Individual provider Active NPI

Jacqueline Marie Gonzalez, AUD

  • Audiologist
  • Phoenix, AZ
National Provider Identifier
1063219400
Registry record updated Mar 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
31158 Issued in OR
Practice address
3805 E Bell Rd
Phoenix, AZ 85032-2105
Phone
(602) 688-6500
NPI assigned
Feb 25, 2025
Last updated
Mar 18, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X DA15980 AZ
Audiologist 231H00000X 31158 OR Primary

Addresses

Primary practice location

3805 E Bell Rd
Phoenix, AZ 85032-2105

Mailing address

7892 S Stephanie LN
Tempe, AZ 85284-1340
Phone (480) 721-9366

Other practice location 1

6320 W Union Hills Dr Ste 170
Glendale, AZ 85308-7152
Phone (602) 688-6500

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260413000135 OR Practitioner - Qualified Audiologist 0840765376 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2024
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2501 Cottontail LN
Somerset, NJ 08873-5125

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DA15980AZMDAudiologist
31158ORMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
North Valley Ear, Nose & Throat Associates, P.C Past Accepting new patients

Networks

  • WA PPO C-SNP
  • devoted network organization-83621310-88c0-4660-8f8d-b8ea8f4dc04e

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1740441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773792000000",
    "number": "1063219400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7892 S STEPHANIE LN",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852841340",
            "telephone_number": "480-721-9366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3805 E BELL RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850322105",
            "telephone_number": "602-688-6500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6320 W Union Hills Dr Ste 170",
            "address_purpose": "LOCATION",
            "city": "Glendale",
            "state": "AZ",
            "postal_code": "853087152",
            "country_code": "US",
            "telephone_number": "602-688-6500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "JACQUELINE",
        "middle_name": "MARIE",
        "credential": "AUD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-02-25",
        "last_updated": "2026-03-18",
        "certification_date": "2026-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "AZ",
            "license": "DA15980",
            "primary": false
        },
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "OR",
            "license": "31158",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2026; 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.