Individual provider Active NPI

Mario Roberto Gonzalez-Torres, M.D., DABPN

  • Child & Adolescent Psychiatry Physician
  • Dorado, PR
National Provider Identifier
1962650085
Registry record updated Mar 29, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
License
17603 Issued in PR
Practice address
332 Calle Mendez Vigo
# B
Dorado, PR 00646-4931
Phone
(787) 800-9959
Fax
(787) 773-1017
NPI assigned
Sep 3, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Child & Adolescent Psychiatry Physician 2084P0804X 17603 PR Primary

Addresses

Primary practice location

332 Calle Mendez Vigo
# B
Dorado, PR 00646-4931

Mailing address

PO Box 363161
San Juan, PR 00936-3161
Phone (787) 415-7115

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
I20120521000189 PR Practitioner - Psychiatry 4284897778 Practice locations: Bayamon, PR

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
University Central del Caribe Escuela de Medicina, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

68 Calle Santa Cruz
Suite 605
Bayamon, PR 00961-7034
Phone (787) 796-0420

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
17603PRMDChild & Adolescent Psychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Alianza Psicoterapeutica de Puerto Rico, PSC Past Accepting new patients
GT Psychiatry LLC Child & Adolescent Psychiatry Past Accepting new patients

Organizations & group practices 2

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": "1220400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522281600000",
    "number": "1962650085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 363161",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009363161",
            "telephone_number": "787-415-7115",
            "fax_number": "787-773-1017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "332 CALLE MENDEZ VIGO",
            "address_2": "# B",
            "city": "DORADO",
            "state": "PR",
            "postal_code": "006464931",
            "telephone_number": "787-800-9959",
            "fax_number": "787-773-1017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ-TORRES",
        "first_name": "MARIO",
        "middle_name": "ROBERTO",
        "name_prefix": "Dr.",
        "credential": "M.D., DABPN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-09-03",
        "last_updated": "2018-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "PR",
            "license": "17603",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dorado, PR

Sources for this page

Verify at the official NPI Registry.