Individual provider Active NPI

Manuel F Gonzalez, M.D

  • Specialist
  • Sumter, SC
National Provider Identifier
1073596813
Registry record updated May 27, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
9747 Issued in SC
Practice address
115 N Sumter St
Suite 305
Sumter, SC 29150-4972
Phone
(803) 934-8348
Fax
(803) 934-8349
NPI assigned
Nov 25, 2005
Last updated
May 27, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 27, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 9747 SC Primary
Hematology & Oncology Physician 207RH0003X 9747 SC

Addresses

Primary practice location

115 N Sumter St
Suite 305
Sumter, SC 29150-4972

Mailing address

115 N Sumter St
Suite 305
Sumter, SC 29150-4972
Phone (803) 934-8348

Other identifiers 2

IdentifierTypeStateIssuer
GP4045MedicaidSC
GP3381MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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
I20061024000537 SC Practitioner - Hematology/Oncology 1557264835 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Hematology/Oncology
Education
Other, 1970
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3 Medical CT
Sumter, SC 29150-4760
Phone (803) 934-8348

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9747SCMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
M Francisco Gonzalez, MD, PA Hematology & Oncology CurrentSince Oct 24, 2006 Accepting new patients
Carolina Family Care, Inc CurrentSince Sep 10, 2020 Accepting new patients
Carolina Family Care, Inc Hematology & Oncology CurrentSince Sep 10, 2020 Accepting new patients
Sumter Nephrology LLC CurrentSince Jun 2, 2013 Accepting new patients
Department of Internal Medicine Past Accepting new patients
Santee Hematology Oncology Inc Hematology & Oncology PastSince Nov 22, 2004 Accepting new patients

Locations

1341 Old Georgetown Rd
Ste C
Mt Pleasant, SC 29464
Phone (843) 884-2175

115 N Sumter St
Sumter, SC 29150
Phone (803) 774-9797

115 N Sumter St
Ste 305
Sumter, SC 29150
Phone (803) 934-8348

3 Medical Ct
Sumter, SC 29150
Phone (803) 934-8348

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 2

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": "1132876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1401148800000",
    "number": "1073596813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 N SUMTER ST",
            "address_2": "SUITE 305",
            "city": "SUMTER",
            "state": "SC",
            "postal_code": "291504972",
            "telephone_number": "803-934-8348",
            "fax_number": "803-934-8349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 N SUMTER ST",
            "address_2": "SUITE 305",
            "city": "SUMTER",
            "state": "SC",
            "postal_code": "291504972",
            "telephone_number": "803-934-8348",
            "fax_number": "803-934-8349"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "MANUEL",
        "middle_name": "F",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-25",
        "last_updated": "2014-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "SC",
            "license": "9747",
            "primary": true
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "SC",
            "license": "9747",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP4045",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP3381",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sumter, SC

Sources for this page

Verify at the official NPI Registry.