Individual provider Active NPI

Juan Diego Gonzalez, MD

  • Internal Medicine Physician
  • Brownsville, TX
National Provider Identifier
1083140917
Registry record updated Aug 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
S4307 Issued in TX
Practice address
3125 W Alton Gloor Blvd
Brownsville, TX 78520-3506
Phone
(956) 544-5700
Fax
(956) 350-9573
NPI assigned
May 11, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X BP10060869 TX
Internal Medicine Physician 207R00000X S4307 TX Primary

Addresses

Primary practice location

3125 W Alton Gloor Blvd
Brownsville, TX 78520-3506

Mailing address

3125 West Alton Gloor Blvd
Brownsville, TX 78520-3506
Phone (956) 544-5700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20200623000202 TX Practitioner - Internal Medicine 2860814720 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University Central del Caribe Escuela de Medicina, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3125 W Alton Gloor Blvd
Brownsville, TX 78520-3506
Phone (956) 544-5700

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of skin lesions31
Removal of nail tissue76
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
BP10060869TXMDInternal Medicine Physician
S4307TXMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ricardo a Abraham Mdpa Internal Medicine CurrentSince Jun 16, 2020 Accepting new patients
Juan Diego Gonzalez MD PA Internal Medicine CurrentSince Aug 1, 2024 Accepting new patients

Locations

3125 W Alton Gloor Blvd
Brownsville, TX 78520
Phone (956) 544-5700

110 Plaza Santa Rosa
Brownsville, TX 78520
Phone (956) 554-3010

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/IJJGAA/Endpoint/IJJGAA

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 and National Provider Directory roles.

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": "1494460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723507200000",
    "number": "1083140917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3125 WEST ALTON GLOOR BLVD",
            "city": "BROWNSVILLE",
            "state": "TX",
            "postal_code": "785203506",
            "telephone_number": "956-544-5700",
            "fax_number": "956-350-9573"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3125 W ALTON GLOOR BLVD",
            "city": "BROWNSVILLE",
            "state": "TX",
            "postal_code": "785203506",
            "telephone_number": "956-544-5700",
            "fax_number": "956-350-9573"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "JUAN",
        "middle_name": "DIEGO",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-05-11",
        "last_updated": "2024-08-13",
        "certification_date": "2024-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "BP10060869",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "S4307",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brownsville, TX

Sources for this page

Verify at the official NPI Registry.