NPIMap

Organization Active NPI

Dr. Jorge R. Matta Gonzalez CSP

  • Adolescent and Children Mental Health Clinic/Center
National Provider Identifier
1932516465
Registry record updated Jul 16, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adolescent and Children Mental Health Clinic/CenterTaxonomy code 261QM0855X
License
340350 Issued in PR
Legal business name
DR. JORGE R. MATTA GONZALEZ CSP
Practice address
Quadrangle Medical Center
50 Luis Munoz Marin Suite 305
Caguas, PUERTO RICO 00725-0000
UM
Phone
(787) 744-0857
NPI assigned
Jul 16, 2014
Last updated
Jul 16, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Jorge R Matta Gonzalez, MDNPI 1316006430
Title
Owner
Phone
(787) 340-0060

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adolescent and Children Mental Health Clinic/Center 261QM0855X 340350 PR Primary

Addresses

Primary practice location

Quadrangle Medical Center
50 Luis Munoz Marin Suite 305
Caguas, PUERTO RICO 00725-0000
UM

Mailing address

PO Box 9634
Caguas, PR 00726-9634
Phone (787) 340-0060

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1405468800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1405468800000",
    "number": "1932516465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9634",
            "city": "CAGUAS",
            "state": "PR",
            "postal_code": "007269634",
            "telephone_number": "787-340-0060"
        },
        {
            "country_code": "UM",
            "country_name": "United States Minor Outlying Islands",
            "address_purpose": "LOCATION",
            "address_type": "FGN",
            "address_1": "QUADRANGLE MEDICAL CENTER",
            "address_2": "50 LUIS MUNOZ MARIN SUITE 305",
            "city": "CAGUAS",
            "state": "PUERTO RICO",
            "postal_code": "007250000",
            "telephone_number": "787-744-0857"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. JORGE R. MATTA GONZALEZ CSP",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-16",
        "last_updated": "2014-07-16",
        "status": "A",
        "authorized_official_last_name": "MATTA GONZALEZ",
        "authorized_official_first_name": "JORGE",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "787-340-0060",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "PR",
            "license": "340350",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.