Active NPI
George Tendero Gonzales, MD
- General Practice Physician
- Fredericksburg, VA
National Provider Identifier
1013975101
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Physician
- License
- 0101022930
- Practice address
- 1212 Powhatan Street
Fredericksburg, VA 22401 - Phone
- (540) 371-4611
- Fax
- (540) 371-4611
- NPI assigned
- May 1, 2006
- 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 |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | 0101022930 | VA | Primary |
Addresses
Primary practice location
1212 Powhatan Street
Fredericksburg, VA 22401
Mailing address
1212 Powhatan Street
Fredericksburg, VA 22401
Phone (540) 371-4611
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 005644704 | Medicaid | VA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in VA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120104000542 | VA | Practitioner - General Practice | 8123294675 | Practice locations: Fredericksburg, VA |
Care Compare profile
Medicare Care Compare- Specialty
- General Practice
- Education
- Other, 1966
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
1212 Powhatan St
Fredericksburg, VA 22401-4619
Phone (540) 371-4611
Hospital & facility affiliations
- Care With Love, LLC
- Mary Washington Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0101022930 | VA | MD | General Practice Physician |
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Home Health Agency
- Fairfax, VA
- NPI 1588152623
-
- General Acute Care Hospital
- Fredericksburg, VA
- NPI 1942288527
-
- Cardiovascular Disease Physician
- Fredericksburg, VA
- NPI 1013089879
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146441600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1735171200000",
"number": "1013975101",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1212 POWHATAN STREET",
"city": "FREDERICKSBURG",
"state": "VA",
"postal_code": "22401",
"telephone_number": "540-371-4611",
"fax_number": "540-371-4611"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1212 POWHATAN STREET",
"city": "FREDERICKSBURG",
"state": "VA",
"postal_code": "22401",
"telephone_number": "540-371-4611",
"fax_number": "540-371-4611"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GONZALES",
"first_name": "GEORGE",
"middle_name": "TENDERO",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-05-01",
"last_updated": "2024-12-26",
"certification_date": "2024-12-26",
"status": "A"
},
"taxonomies": [
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "VA",
"license": "0101022930",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "005644704",
"state": "VA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Fredericksburg, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.