Individual provider Active NPI

Twain Gonzales, PSY.D.

  • Clinical Psychologist
  • Newtown, PA
National Provider Identifier
1124192281
Registry record updated Apr 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PS005925L Issued in PA
Practice address
219 Washington Ave
Newtown, PA 18940-1941
Phone
(302) 430-9997
NPI assigned
Nov 20, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 24, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X B1-0000865 DE
Clinical Psychologist 103TC0700X PY8532 FL
Clinical Psychologist 103TC0700X PS005925L PA Primary

Addresses

Primary practice location

219 Washington Ave
Newtown, PA 18940-1941

Mailing address

219 Washington Ave
Newtown, PA 18940-1941
Phone (302) 430-9997

Other identifiers 1

IdentifierTypeStateIssuer
1000030388MedicaidDE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211220001804 PA Practitioner - Clinical Psychologist 3274924618 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

219 Washington Ave
Newtown, PA 18940-1941
Phone (302) 430-9997

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
B1-0000865DEMDClinical Psychologist
PY8532FLMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Bucks County Psychological and Assessment Services LLC CurrentSince Oct 25, 2021 Accepting new patients
Che Senior Care Therapy Services PC Clinical CurrentSince Jul 24, 2022 Accepting new patients

Locations

630 Freedom Business Ctr Dr
Fl 3
King of Prussia, PA 19406
Phone (484) 686-1008

208 Fernbrook Ave
Wyncote, PA 19095
Phone (610) 668-8553

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.

NPI Registry JSON

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

{
    "created_epoch": "1163980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556064000000",
    "number": "1124192281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "219 WASHINGTON AVE",
            "city": "NEWTOWN",
            "state": "PA",
            "postal_code": "189401941",
            "telephone_number": "302-430-9997",
            "fax_number": "302-644-4909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "219 WASHINGTON AVE",
            "city": "NEWTOWN",
            "state": "PA",
            "postal_code": "189401941",
            "telephone_number": "302-430-9997"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALES",
        "first_name": "TWAIN",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-20",
        "last_updated": "2019-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "DE",
            "license": "B1-0000865",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY8532",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "PA",
            "license": "PS005925L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1000030388",
            "state": "DE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newtown, PA

Sources for this page

Verify at the official NPI Registry.