Individual provider Active NPI

Nikolai Y Gonzales, M.D.

  • Anesthesiology Physician
  • Salem, MA
National Provider Identifier
1053379453
Registry record updated Jan 11, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
224717 Issued in MA
Practice address
81 Highland Ave
Anesthesia Assoc of Salem Inc
Salem, MA 01970
Phone
(978) 354-3384
NPI assigned
May 3, 2006
Last updated
Jan 11, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 224717 MA Primary

Addresses

Primary practice location

81 Highland Ave
Anesthesia Assoc of Salem Inc
Salem, MA 01970

Mailing address

56 King St
Swampscott, MA 01907-2131
Phone (978) 354-3384

Other identifiers 1

IdentifierTypeStateIssuer
2116154MedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050715000354 MA Practitioner - Anesthesiology 2365478823 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Tufts University School of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mass General Brigham Medical Group, Inc.Group PAC ID 3971987108, 140 clinicians

Practice addresses (Care Compare)

47 Middlesex Tpke
Burlington, MA 01803-4945
Phone (857) 282-8100

81 Highland Ave
Salem, MA 01970-2714
Phone (617) 726-4121

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
224717MAMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The General Hospital Corporation CurrentSince Oct 1, 2006 Accepting new patients
Mass General Brigham Medical Group, Inc. Anesthesiology CurrentSince Jul 1, 2024 Accepting new patients
General Hospital Corp Current Accepting new patients
NSPG Billing LLC Past Accepting new patients
Anesthetics of Massachusetts, PC Anesthesiology Past Accepting new patients

Locations

55 Fruit St
Boston, MA 02114

55 Fruit St
#2
Boston, MA 02114
Phone (617) 726-2967

47 Middlesex Tpke
Burlington, MA 01803
Phone (857) 282-8100

57 Prospect St
Nantucket, MA 02554
Phone (508) 228-1200

81 Highland Ave
Salem, MA 01970
Phone (978) 354-4009

Interoperability endpoints

  • Direct secure messaging: gonzales.nikolai.mgh@direct.partners.masshiway.net

Organizations & group practices 6

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 1

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": "1146614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1263168000000",
    "number": "1053379453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "56 KING ST",
            "city": "SWAMPSCOTT",
            "state": "MA",
            "postal_code": "019072131",
            "telephone_number": "978-354-3384"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "81 HIGHLAND AVE",
            "address_2": "ANESTHESIA ASSOC OF SALEM INC",
            "city": "SALEM",
            "state": "MA",
            "postal_code": "01970",
            "telephone_number": "978-354-3384"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALES",
        "first_name": "NIKOLAI",
        "middle_name": "Y",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-03",
        "last_updated": "2010-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MA",
            "license": "224717",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2116154",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, MA

Sources for this page

Verify at the official NPI Registry.