Nicolas Antonio Gonzalez, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

29730 Issued in AZ

Practice address

2600 E Southern Ave
BLDG. H
Tempe, AZ 85282

Phone

(480) 699-7248

Fax

(480) 664-1961

NPI assigned

Jul 15, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Adelante Healthcare, Inc

  • Federally Qualified Health Center (FQHC)
  • Phoenix, AZ
  • NPI 1215734124
  NPD (past)

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

{
    "created_epoch": "1121385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1307491200000",
    "number": "1013916659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2600 E SOUTHERN AVE",
            "address_2": "BLDG. H",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "85282",
            "telephone_number": "480-699-7248",
            "fax_number": "480-664-1961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 E SOUTHERN AVE",
            "address_2": "BLDG. H",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "85282",
            "telephone_number": "480-699-7248",
            "fax_number": "480-664-1961"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "NICOLAS",
        "middle_name": "ANTONIO",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-15",
        "last_updated": "2011-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "AZ",
            "license": "29730",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET",
            "identifier": "3Z0260",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "610560",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Corina Melissa Gonzalez Zepeda
• Cecilia Gonzalez, RBT
• Daisy D Gonzalez
• Erika Gonzalez
• Galilea Gonzalez
• Good Health Medical, PLLC
• Good Health Medical, PLLC
• James Tyler Good
• Evelyn Esther Goodell, L.P.C.
• Alystra Gooden, LMT

• Pediatrics Physician in Tempe, AZ
• Providers in Tempe, AZ by specialty
• Pediatrics Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2011; 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.