Raphy Alexis Gonzalez, MD
Individual provider Active NPI General Practice Physician · Hatillo, PR
NPI 1972534501 · NPPES record last updated May 14, 2024
Key facts
- NPI
- 1972534501
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Physician 208D00000X
- License
- 15225 (PR)
- Practice address
- Carr #130 KM 5.4 Bo Naranjito Sector Lechuga
Hatillo, PR 00659-9415 - Phone
- (787) 820-3232
- Fax
- (787) 820-3232
- NPI assigned
- Jul 5, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 7
Medicare Care Compare profile
- Specialty
- General Practice
- Education
- Other, 2002
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
Carr 130 KM 5
Hatillo, PR 00659
Phone (787) 820-3232
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PR
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050715000904 | PR | Practitioner - General Practice | 0547296956 |
Reassigns benefits to 2 organizations Practice locations: Hatillo, PR |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 15225 | PR | MD | General Practice Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Metro Pavia Healthcare Centers Inc | Current | Accepting new patients | |
| Integrate Community Health System | Current |
Accepting new patients | |
| Integrate Community Health System | Current | Accepting new patients | |
| Metro Pavia Healthcare Centers Inc | Current |
Accepting new patients | |
| Integrate Community Health System, Inc. | Current |
Accepting new patients | |
| Metro Pavia Healthcare Center | Current |
Accepting new patients | |
| Policlinica de Familia Factor Inc | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | 15225 | PR | Yes |
Addresses
Primary practice location
Carr #130 KM 5.4 Bo Naranjito Sector Lechuga
Hatillo, PR 00659-9415
Mailing address
PO Box 141322
Arecibo, PR 00614-1322
Phone (787) 820-0553
Other providers in Hatillo, PR
- Carmen P Gonzalez
- Cristina B Gonzalez
- Jacqueline Gonzalez
- Johannie Gonzalez
- Maria del Mar Gonzalez
- Rut Violeta Gonzalez
- Alberto G Grana
- Green Hills Pharmacy Corp.
- Grupo Medico Camuy Ipa 23
- Grupo Medico de Camuy, Inc.
All providers in Hatillo, PR · General Practice Physician in Puerto Rico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 14, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.