NPIMap

Organization Active NPI

Luis C Gonzalez MD

  • Surgery Physician
  • Bradford, PA
National Provider Identifier
1154636686
Registry record updated Aug 9, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
MD0549041 Issued in PA
Legal business name
LUIS C GONZALEZ MD
Practice address
181 Interstate Pkwy
Bradford, PA 16701-1041
Phone
(814) 362-4345
Fax
(814) 362-1178
NPI assigned
Aug 9, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2010

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

Authorized official

Name
Dr. Luis Carlos Gonzalez, MDNPI 1871519637
Title
Owner
Phone
(814) 362-4345

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 208600000X MD0549041 PA Primary
Surgical Physician AssistantGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 363AS0400X 363AS0400X PA

Addresses

Primary practice location

181 Interstate Pkwy
Bradford, PA 16701-1041

Mailing address

181 Interstate Pkwy
Bradford, PA 16701-1041
Phone (814) 362-4345

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1281312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1281312000000",
    "number": "1154636686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "181 INTERSTATE PKWY",
            "city": "BRADFORD",
            "state": "PA",
            "postal_code": "167011041",
            "telephone_number": "814-362-4345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "181 INTERSTATE PKWY",
            "city": "BRADFORD",
            "state": "PA",
            "postal_code": "167011041",
            "telephone_number": "814-362-4345",
            "fax_number": "814-362-1178"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUIS C GONZALEZ MD",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-09",
        "last_updated": "2010-08-09",
        "status": "A",
        "authorized_official_last_name": "GONZALEZ",
        "authorized_official_first_name": "LUIS",
        "authorized_official_middle_name": "CARLOS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "814-362-4345",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Surgery",
            "state": "PA",
            "license": "MD0549041",
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physician Assistant, Surgical",
            "state": "PA",
            "license": "363AS0400X",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bradford, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.