Individual provider Active NPI

Florie Gonzales Jr., OTR/L, CHT

  • Occupational Therapist
  • Everett, WA
National Provider Identifier
1003823360
Registry record updated Feb 27, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT60669325 Issued in WA
Practice address
3927 Rucker Ave
Everett, WA 98201-4833
Phone
(425) 339-5491
Fax
(425) 339-4219
NPI assigned
Aug 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Military Health Care Provider 171000000X KY-R2223 KY
Occupational Therapist 225X00000X OT60669325 WA Primary

Addresses

Primary practice location

3927 Rucker Ave
Everett, WA 98201-4833

Mailing address

PO Box 5127
Everett, WA 98206-5127
Phone (425) 339-5491

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170315002555 WA Practitioner - Occupational Therapist in Private Practice 7618252537 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northwest Return to Work Mt VernonGroup PAC ID 6204151152, 5 clinicians

Practice addresses (Care Compare)

1600 Roosevelt Ave
Suite B
Mount Vernon, WA 98273-2646
Phone (360) 424-5215

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
KY-R2223KYMDMilitary Health Care Provider
OT60669325WAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Capstone Health Services Inc. Occupational Therapist CurrentSince Jun 24, 2022 Accepting new patients
Northwest Return to Work Mt Vernon CurrentSince Sep 19, 2017 Accepting new patients
Valley Rehab Physical Therapy Inc CurrentSince Sep 19, 2017 Accepting new patients
Capstone Health Services Inc. Occupational Therapist CurrentSince Jun 24, 2022 Accepting new patients
Capstone Health Services Inc. Current Accepting new patients

Locations

414 W Bakerview Rd
Ste 110
Bellingham, WA 98226
Phone (360) 223-3696

8862 Bender Rd
Ste 101
Lynden, WA 98264
Phone (360) 255-7876

1600 Roosevelt Ave
Ste B
Mount Vernon, WA 98273
Phone (360) 424-5215

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488153600000",
    "number": "1003823360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5127",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982065127",
            "telephone_number": "425-339-5491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3927 RUCKER AVE",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982014833",
            "telephone_number": "425-339-5491",
            "fax_number": "425-339-4219"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALES",
        "first_name": "FLORIE",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "OTR/L, CHT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-01",
        "last_updated": "2017-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171000000X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider",
            "state": "KY",
            "license": "KY-R2223",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WA",
            "license": "OT60669325",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Everett, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.