Individual provider Active NPI

Bernadette Beatrice Gonzalez, PA

  • Medical Physician Assistant
  • West Hollywood, CA
National Provider Identifier
1083247175
Registry record updated Aug 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA58240 Issued in CA
Practice address
8700 Beverly Blvd
West Hollywood, CA 90048-1804
Phone
(310) 423-8780
NPI assigned
Feb 17, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X
Medical Physician Assistant 363AM0700X PA58240 CA Primary

Addresses

Primary practice location

8700 Beverly Blvd
West Hollywood, CA 90048-1804

Mailing address

2704 W 80TH St
Inglewood, CA 90305-1409
Phone (323) 767-4614

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200820003561 CA Practitioner - Physician Assistant 0547686529 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Commons Clinic Medical Group, PCGroup PAC ID 6204221096, 21 clinicians

Practice addresses (Care Compare)

13160 Mindanao Way
Suite 300
Marina del Rey, CA 90292-6393
Phone (310) 437-7925

2811 Wilshire Blvd
Suite 850
Santa Monica, CA 90403-4812
Phone (310) 828-7757

Hospital & facility affiliations

  • Saint John'S Health Center Hospital, Santa Monica, CA, CCN 050290
  • Cedars-Sinai Medical Center Hospital, Los Angeles, CA, CCN 050625

Merit-based Incentive Payment System (MIPS)

Final score
93.23 of 100Reported as group
Quality
77.83
Promoting interoperability
98
Improvement activities
40
Cost
71.17

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA58240CAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Cedars-Sinai Medical Center CurrentSince Sep 1, 2020 Accepting new patients
Cedars-Sinai Medical Center CurrentSince Sep 1, 2020 Accepting new patients
Commons Clinic Medical Network, PC Past Accepting new patients

Locations

2080 Century Park E
Ste 1204
Los Angeles, CA 90067
Phone (310) 430-1310

8700 Beverly Blvd
West Hollywood, CA 90048
Phone (310) 385-3291

Organizations & group practices 5

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 3

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": "1581897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597622400000",
    "number": "1083247175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2704 W 80TH ST",
            "city": "INGLEWOOD",
            "state": "CA",
            "postal_code": "903051409",
            "telephone_number": "323-767-4614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8700 BEVERLY BLVD",
            "city": "WEST HOLLYWOOD",
            "state": "CA",
            "postal_code": "900481804",
            "telephone_number": "310-423-8780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "BERNADETTE",
        "middle_name": "BEATRICE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-17",
        "last_updated": "2020-08-17",
        "certification_date": "2020-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA58240",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Hollywood, CA

Sources for this page

Verify at the official NPI Registry.