Individual provider Active NPI

Cristobal Gomez Duarte, MD

  • Gastroenterology Physician
  • San Juan, PR
National Provider Identifier
1972589414
Registry record updated Feb 14, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
5846 Issued in PR
Practice address
1449 Americo Salas
Ste 103
San Juan, PR 00909-2104
Phone
(787) 722-1717
Fax
(787) 723-1595
NPI assigned
Dec 16, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 14, 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 5846 PR Primary

Addresses

Primary practice location

1449 Americo Salas
Ste 103
San Juan, PR 00909-2104

Mailing address

690 Calle Cesar Gonzalez
Apt Ph307
San Juan, PR 00918-3913
Phone (787) 722-1717

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5846PRMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Recinto de Ciencias Medicas Gastroenterology Past Accepting new patients
Nova Gi LLC Gastroenterology 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1134691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329177600000",
    "number": "1972589414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "690 CALLE CESAR GONZALEZ",
            "address_2": "APT PH307",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009183913",
            "telephone_number": "787-722-1717",
            "fax_number": "787-723-1595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1449 AMERICO SALAS",
            "address_2": "STE 103",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009092104",
            "telephone_number": "787-722-1717",
            "fax_number": "787-723-1595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOMEZ DUARTE",
        "first_name": "CRISTOBAL",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-12-16",
        "last_updated": "2012-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "PR",
            "license": "5846",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2012; 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.