Individual provider Active NPI

Javier Gonzalez

  • Physician Assistant
  • Gainesville, FL
National Provider Identifier
1003652090
Registry record updated Oct 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
9119274 Issued in FL
Practice address
7540 W University Ave
Gainesville, FL 32607-7609
Phone
(352) 647-9700
NPI assigned
Jul 8, 2024
Last updated
Oct 9, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 9, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 9119274 FL Primary

Addresses

Primary practice location

7540 W University Ave
Gainesville, FL 32607-7609

Mailing address

7540 W University Ave
Gainesville, FL 32607-7609
Phone (352) 647-9700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241024001155 FL Practitioner - Physician Assistant 3971036328 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
May accept Medicare assignment
Group practices
Lake Area Physical Therapy Inc.Group PAC ID 3678604840, 372 clinicians

Practice addresses (Care Compare)

2118 SW 20TH PL
Ocala, FL 34471-0869
Phone (813) 978-9700

3334 Capital Medical Blvd
Suite 400
Tallahassee, FL 32308-4470
Phone (850) 877-8174

7540 W University Ave
Gainesville, FL 32607-7609
Phone (813) 978-9700

PO Box
Suite 1099
Melrose, FL 32666-1099

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
9119274FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Tallahassee Orthopedic Clinic III, P.L. CurrentSince Oct 17, 2024 Accepting new patients
Coastal Orthopedics & Sports Medicine of Southwest Florida PA Past Accepting new patients
Tallahassee Orthopedic Clinic III PL Past Accepting new patients

Locations

7540 W University Ave
Gainesville, FL 32607
Phone (352) 265-0335

2118 SW 20th Pl
Ste 102
Ocala, FL 34471
Phone (352) 291-1022

13020 N Telecom Pkwy
Temple Terrace, FL 33637

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: javier.gonzalez.1@18802.direct.athenahealth.com

Organizations & group practices 5

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 6

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": "1720396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728432000000",
    "number": "1003652090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7540 W UNIVERSITY AVE",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326077609",
            "telephone_number": "352-647-9700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7540 W UNIVERSITY AVE",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326077609",
            "telephone_number": "352-647-9700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "JAVIER",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-07-08",
        "last_updated": "2024-10-09",
        "certification_date": "2024-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "9119274",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, FL

Sources for this page

Verify at the official NPI Registry.