NPIMap

Individual provider Active NPI

Ivan Antunez Gonzalez, M.D.

  • Gastroenterology Physician
  • Guaynabo, PR
National Provider Identifier
1962457408
Registry record updated Sep 17, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
13434 Issued in PR
Practice address
PMB 311
Num 35 Juan C Borbon Suite 67
Guaynabo, PR 00969
Phone
(787) 756-5900
NPI assigned
May 23, 2006
Last updated
Sep 17, 2012By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 17, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 13434 PR Primary

Addresses

Primary practice location

PMB 311
Num 35 Juan C Borbon Suite 67
Guaynabo, PR 00969

Mailing address

PMB 311
Num 35 Juan C Borbon Suite 67
Guaynabo, PR 00969
Phone (787) 756-5900

Other names 1

  • Dr. Ivan Antunez Gonzalez Professional name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040209000705 PR Practitioner - Gastroenterology 9436043817 Reassigns benefits to 3 organizations
Practice locations: Aibonito, PR; Hato Rey, PR; San Juan, PR

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
University of Puerto Rico School of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hospital Espanol Auxilio Mutuo de Puerto Rico, Inc.Group PAC ID 4183602832, shared by 6 NPIs, 54 clinicians

Practice addresses (Care Compare)

715 Ave Ponce de Leon
Stop 37.5
San Juan, PR 00917-5032
Phone (787) 758-2000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
78.6 of 100Reported as group
Quality
66.19
Improvement activities
40
Cost
73.97

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy102
Upper gastrointestinal (GI) endoscopy for acid reflux70

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mennonite General Hospital Inc CurrentSince Mar 1, 2017 Accepting new patients
Mennonite General Hospital Inc. CurrentSince Mar 1, 2017 Accepting new patients
Hospital Espanol Auxilio Mutuo de Puerto Rico, Inc. CurrentSince Jan 7, 2020 Accepting new patients
Hospital Espanol Auxilio Mutuo de Puerto Rico, Inc. CurrentSince Aug 24, 2011 Accepting new patients
Mennonite General Hospital Inc Current Accepting new patients
Hospital Espanol Auxilio Mutuo de Puerto Rico, Inc. CurrentSince Aug 24, 2011 Accepting new patients
Recinto de Ciencias Medicas Gastroenterology Past Accepting new patients
Ym Gastro LLC Gastroenterology Past Accepting new patients

Locations

715 Ave Ponce de Leon
San Juan, PR 00917
Phone 7877582000 ext. 3216

715 Ave Ponce de Leon
Stop 375
San Juan, PR 00917
Phone 7877582000 ext. 3216

Organizations & group practices 8

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

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1148342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1347840000000",
    "number": "1962457408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PMB 311",
            "address_2": "NUM 35 JUAN C BORBON SUITE 67",
            "city": "GUAYNABO",
            "state": "PR",
            "postal_code": "00969",
            "telephone_number": "787-756-5900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "PMB 311",
            "address_2": "NUM 35 JUAN C BORBON SUITE 67",
            "city": "GUAYNABO",
            "state": "PR",
            "postal_code": "00969",
            "telephone_number": "787-756-5900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANTUNEZ GONZALEZ",
        "first_name": "IVAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-23",
        "last_updated": "2012-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "PR",
            "license": "13434",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "IVAN",
            "last_name": "ANTUNEZ GONZALEZ",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Guaynabo, PR

Sources for this page

Verify at the official NPI Registry.