Individual provider Active NPI

Maria De Lourdes Gonzalez, M.D.

  • General Practice Physician
  • Isabela, PR
National Provider Identifier
1942362074
Registry record updated Dec 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
14470 Issued in PR
Practice address
Ave Agustin Ramos Calero
KM 1.4
Isabela, PR 00662
Phone
(787) 830-2705
Fax
(787) 830-3059
NPI assigned
Dec 14, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 15, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 14470 PR Primary

Addresses

Primary practice location

Ave Agustin Ramos Calero
KM 1.4
Isabela, PR 00662

Mailing address

110 Calle Vista Hermosa
Isabela, PR 00662-3359
Phone (787) 479-7522

Other practice location 1

Carr 113
KM 2.2
Isabela, PR 00662
Phone (787) 830-1654

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070316000298 PR Practitioner - General Practice 6103929831 Reassigns benefits to 1 organization
Practice locations: Isabela, PR

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Cima HMO Corp Family Medicine CurrentSince Apr 7, 2020 Accepting new patients
Terapia Con Amor LLC Past Accepting new patients
Dra Maria de L Gonzalez LLC General Practice Past Accepting new patients

Locations

7342 Ave Sfc Agustin Ramos Calero
Isabela, PR 00662
Phone (787) 830-8866

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1166054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607990400000",
    "number": "1942362074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 CALLE VISTA HERMOSA",
            "city": "ISABELA",
            "state": "PR",
            "postal_code": "006623359",
            "telephone_number": "787-479-7522",
            "fax_number": "787-830-1654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "AVE AGUSTIN RAMOS CALERO",
            "address_2": "KM 1.4",
            "city": "ISABELA",
            "state": "PR",
            "postal_code": "00662",
            "telephone_number": "787-830-2705",
            "fax_number": "787-830-3059"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Carr 113",
            "address_2": "KM 2.2",
            "address_purpose": "LOCATION",
            "city": "Isabela",
            "state": "PR",
            "postal_code": "00662",
            "country_code": "US",
            "telephone_number": "787-830-1654",
            "fax_number": "787-830-1654",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "MARIA",
        "middle_name": "DE LOURDES",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-14",
        "last_updated": "2020-12-15",
        "certification_date": "2020-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "14470",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Isabela, PR

Sources for this page

Verify at the official NPI Registry.