Individual provider Active NPI

Angela Maria Gonzalez, DO

  • Emergency Medicine Physician
  • New Brunswick, NJ
National Provider Identifier
1083177703
Registry record updated Sep 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
25MB11391100 Issued in NJ
Practice address
254 Easton Ave
New Brunswick, NJ 08901-1766
Phone
(732) 745-8600
NPI assigned
Apr 9, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 25MB11391100 NJ Primary

Addresses

Primary practice location

254 Easton Ave
New Brunswick, NJ 08901-1766

Mailing address

92 Richfield CT
Clifton, NJ 07012-1322
Phone (973) 652-5258

Other practice location 1

30 Prospect Ave
Hackensack, NJ 07601-1915
Phone (551) 996-2300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20220903000000 NJ Practitioner - Emergency Medicine 9335523752 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Touro Un College of Osteopathic Medicine, Vallejo, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southern Bank Emergency Physicians LLCGroup PAC ID 9436202421, 11 clinicians

Practice addresses (Care Compare)

254 Easton Ave
New Brunswick, NJ 08901-1766
Phone (732) 745-8525

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Bank Emergency Physicians LLC Emergency Medicine CurrentSince Aug 1, 2022 Accepting new patients
Emergency Physician Associates of North Jersey P C Emergency Medicine CurrentSince Aug 1, 2023 Accepting new patients

Locations

254 Easton Ave
New Brunswick, NJ 08901
Phone (732) 565-5453

97 W Parkway
Pompton Plns, NJ 07444
Phone (973) 831-5000

99 Beauvoir Ave
Summit, NJ 07901
Phone (908) 522-2232

Organizations & group practices 3

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 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": "1554768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662508800000",
    "number": "1083177703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "92 RICHFIELD CT",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "070121322",
            "telephone_number": "973-652-5258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "254 EASTON AVE",
            "city": "NEW BRUNSWICK",
            "state": "NJ",
            "postal_code": "089011766",
            "telephone_number": "732-745-8600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "30 Prospect Ave",
            "address_purpose": "LOCATION",
            "city": "Hackensack",
            "state": "NJ",
            "postal_code": "076011915",
            "country_code": "US",
            "telephone_number": "551-996-2300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "ANGELA",
        "middle_name": "MARIA",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-09",
        "last_updated": "2022-09-07",
        "certification_date": "2022-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NJ",
            "license": "25MB11391100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Brunswick, NJ

Sources for this page

Verify at the official NPI Registry.