NPIMap

Organization Active NPI

Juan a Gonzalez MD PA

  • Surgery Physician
  • Union City, NJ
National Provider Identifier
1013001999
Registry record updated Jan 4, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
25MA4258800 Issued in NJ
Legal business name
JUAN A GONZALEZ MD PA
Practice address
3196 Kennedy Blvd
2ND Floor
Union City, NJ 07087-2436
Phone
(201) 795-9080
Fax
(201) 795-9434
NPI assigned
Oct 3, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2012

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

Authorized official

Name
Dr. Juan A Gonzalez, MD
Title
President
Phone
(201) 795-9080

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208600000X 25MA4258800 NJ Primary
Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208600000X 25MA07273600 NJ

Addresses

Primary practice location

3196 Kennedy Blvd
2ND Floor
Union City, NJ 07087-2436

Mailing address

3196 Kennedy Blvd
Mailbox 16a
Union City, NJ 07087-2436
Phone (201) 795-9080

Other identifiers 1

IdentifierTypeStateIssuer
0003875MedicaidNJ

National Provider Directory

National Provider Directory

Locations

1 Marine View Plz
Hoboken, NJ 07030
Phone (201) 216-1040

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1325635200000",
    "number": "1013001999",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3196 KENNEDY BLVD",
            "address_2": "MAILBOX 16A",
            "city": "UNION CITY",
            "state": "NJ",
            "postal_code": "070872436",
            "telephone_number": "201-795-9080",
            "fax_number": "201-795-9434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3196 KENNEDY BLVD",
            "address_2": "2ND FLOOR",
            "city": "UNION CITY",
            "state": "NJ",
            "postal_code": "070872436",
            "telephone_number": "201-795-9080",
            "fax_number": "201-795-9434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JUAN A GONZALEZ MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-03",
        "last_updated": "2012-01-04",
        "status": "A",
        "authorized_official_last_name": "GONZALEZ",
        "authorized_official_first_name": "JUAN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "201-795-9080",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": "NJ",
            "license": "25MA4258800",
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": "NJ",
            "license": "25MA07273600",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0003875",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Union City, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 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.