Active NPI
Pedro Mario Gonzalez, MS, CTRS
- Recreation Therapist
- Montrose, NY
National Provider Identifier
1003428228
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Recreation Therapist
- License
- 13152
- Practice address
- 2094 Albany Post Rd
Montrose, NY 10548-1454 - Phone
- (914) 737-4400
- NPI assigned
- Aug 19, 2020
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Recreation Therapist | 225800000X | 13152 | NY | Primary |
Addresses
Primary practice location
2094 Albany Post Rd
Montrose, NY 10548-1454
Mailing address
703 Swan Hollow Rd
Monroe, NY 10950-5108
Phone (516) 528-3222
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)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 13152 | NY | MD | Recreation Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1597795200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1597795200000",
"number": "1003428228",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "703 SWAN HOLLOW RD",
"city": "MONROE",
"state": "NY",
"postal_code": "109505108",
"telephone_number": "516-528-3222"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2094 ALBANY POST RD",
"city": "MONTROSE",
"state": "NY",
"postal_code": "105481454",
"telephone_number": "914-737-4400"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GONZALEZ",
"first_name": "PEDRO",
"middle_name": "MARIO",
"name_prefix": "Mr.",
"credential": "MS, CTRS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-08-19",
"last_updated": "2020-08-19",
"certification_date": "2020-08-19",
"status": "A"
},
"taxonomies": [
{
"code": "225800000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Recreation Therapist",
"state": "NY",
"license": "13152",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Montrose, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.