Jorge Antonio Gonzalez, MD

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

19558 Issued in OK

Practice address

5010 E 68TH St Ste 102
Tulsa, OK 74136-3341

Phone

(918) 236-5881

Fax

(918) 236-5885

NPI assigned

May 20, 2006

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 1

Medicare fee-for-service enrollment

Enrolled in OK, TX2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Creek Nation Hospital & Clinics

  • Clinic/Center
  • Muskogee, OK
  • NPI 1366593923
  Medicare reassignment NPD
• Creek Nation Hospital & Clinics

  • Family Medicine Physician
  • Okemah, OK
  • NPI 1467053173

  TX

  Medicare reassignment NPD
• Creek Nation Hospital & Clinics

  • General Acute Care Hospital
  • Okmulgee, OK
  • NPI 1033511480
  NPD
• Creek Nation Hospital & Clinics

  • Clinic/Center
  • Muskogee, OK
  • NPI 1922873611
  NPD
• Summit Medical Center

  • General Acute Care Hospital
  • Edmond, OK
  • NPI 1356574560
  NPD (past)

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

{
    "created_epoch": "1148083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560211200000",
    "number": "1073567392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5010 E 68TH ST STE 102",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741363341",
            "telephone_number": "918-236-5881",
            "fax_number": "918-236-5885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5010 E 68TH ST STE 102",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741363341",
            "telephone_number": "918-236-5881",
            "fax_number": "918-236-5885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "JORGE",
        "middle_name": "ANTONIO",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-20",
        "last_updated": "2019-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "OK",
            "license": "19558",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100020260C",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Blanca Estela Gonzalez
• Claudia Elena Gonzalez
• Daniel Gonzalez
• Gladis Gonzalez
• Herman Gonzalez, DO
• Karla Gonzalez
• Krystin Alishia Gonzalez
• Lori Dawn Gonzalez, LPC
• Marcie Gonzalez
• Maximiana Gonzalez

• Neurology Physician in Tulsa, OK
• Providers in Tulsa, OK by specialty
• Neurology Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2019; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.