Gustavo Gonzales, APN,C

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

26NJ00106400 Issued in NJ

Practice address

25-27 E Dickerson St Ste 101
Dover, NJ 07801-4655

Phone

(973) 361-0750

NPI assigned

Jun 26, 2006

Last updated

Aug 7, 2013By the provider in NPPES

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 names 1

• Gustavo Gonzales Other name

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: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/19916/brand/1/csg/1/fhir/r4

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.

• Fellowship Senior Living, Inc.

  • Skilled Nursing Facility
  • Basking Ridge, NJ
  • NPI 1659411437

  Adult Health

  Medicare reassignment NPD
• Health and Wellness Center of Dover LLC

  • Adult Health Nurse Practitioner
  • Dover, NJ
  • NPI 1245665710
  Authorized official Same address or phone
• Fellowship Village Inc.

  dba Fellowship Garden State Hospice

  • Community Based Hospice Care Agency
  • Basking Ridge, NJ
  • NPI 1386191302
  NPD

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

{
    "created_epoch": "1151280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1375833600000",
    "number": "1124055389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25-27 E DICKERSON ST STE 101",
            "city": "DOVER",
            "state": "NJ",
            "postal_code": "078014655",
            "telephone_number": "973-361-0750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25-27 E DICKERSON ST STE 101",
            "city": "DOVER",
            "state": "NJ",
            "postal_code": "078014655",
            "telephone_number": "973-361-0750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALES",
        "first_name": "GUSTAVO",
        "name_prefix": "Mr.",
        "credential": "APN,C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-26",
        "last_updated": "2013-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NJ",
            "license": "26NJ00106400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GUSTAVO",
            "last_name": "GONZALES",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Susan Glaser
• Rachel Talia Gold
• Steven Jay Golombek, M.D.
• Jewel Gomez, PHARMD
• Philip Goncalves, PA-C
• Leoncio G Gonzalez, MD
• Grande Center for Post Acute and Nursing Care LLC (Excel Care at Dover)
• Michael G Grant, DC
• Wayne Lewis Greene, MD
• Dahiana P. Grisales, LCSW

• Adult Health Nurse Practitioner in Dover, NJ
• Providers in Dover, NJ by specialty
• Adult Health Nurse Practitioner in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2013; 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.