NPIMap

Individual provider Active NPI

David Gonzalez, DO

  • Internal Medicine Physician
  • Philadelphia, PA
National Provider Identifier
1164059697
Registry record updated Oct 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
OS023981 Issued in PA
Practice address
3401 N Broad St
Philadelphia, PA 19140-5103
Phone
(215) 707-1622
NPI assigned
Mar 25, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X OS023981 PA Primary

Addresses

Primary practice location

3401 N Broad St
Philadelphia, PA 19140-5103

Mailing address

3500 N Broad St
Philadelphia, PA 19140-4106

Other practice location 1

133 W Hunting Park Ave
Philadelphia, PA 19140-2717
Phone (215) 324-0600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, PA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20230705003346 OH Practitioner - Internal Medicine 9638581846 Reassigns benefits to 1 organization
I20240807003710 PA Practitioner - Internal Medicine 9638581846 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Lake Erie College of Osteopathic Medicine, Bradenton, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fair Hill Community PhysiciansGroup PAC ID 1850746215, 11 clinicians
Temple Faculty Practice Plan IncGroup PAC ID 0345588711, 1,325 clinicians

Practice addresses (Care Compare)

133 W Hunting Park Ave
Philadelphia, PA 19140-2717
Phone (215) 324-0600

3401 N Broad St
Philadelphia, PA 19140-5103
Phone (215) 707-3008

Hospital & facility affiliations

  • Temple University Hospital Hospital, Philadelphia, PA, CCN 390027

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Temple Faculty Practice Plan, Inc CurrentSince Aug 1, 2024 Accepting new patients
Temple Faculty Practice Plan Inc CurrentSince Aug 1, 2024 Accepting new patients
Partners Physician Group Internal Medicine CurrentSince Jul 1, 2023 Accepting new patients
Temple Faculty Practice Plan Inc Current Accepting new patients
Fair Hill Community Physicians Internal Medicine CurrentSince Aug 1, 2024 Accepting new patients
Partners Physician Group CurrentSince Jul 1, 2023 Accepting new patients
Temple University Hospital, Inc Past Accepting new patients
Temple Faculty Practice Plan Inc Past Accepting new patients

Locations

224 W Exchange St
Ste 160
Akron, OH 44302
Phone (330) 344-6505

1 Akron General Ave
Akron, OH 44307
Phone (330) 344-5760

3401 N Broad St
Philadelphia, PA 19140
Phone (215) 707-3807

133 W Hunting Park Ave
Philadelphia, PA 19140
Phone (215) 324-0600

3500 N Broad St
Philadelphia, PA 19140
Phone (215) 707-3656

100 E Lehigh Ave
Philadelphia, PA 19125
Phone (215) 707-1200

1331 E Wyoming Ave
Philadelphia, PA 19124
Phone (215) 537-7400

Organizations & group practices 8

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 8

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": "1585094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727827200000",
    "number": "1164059697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3500 N BROAD ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191404106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 N BROAD ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191405103",
            "telephone_number": "215-707-1622"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "133 W Hunting Park Ave",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191402717",
            "country_code": "US",
            "telephone_number": "215-324-0600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "DAVID",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-25",
        "last_updated": "2024-10-02",
        "certification_date": "2024-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "OS023981",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.