NPIMap

Individual provider Active NPI

Luisito C. Gonzales, M.D.

  • Cardiovascular Disease Physician
  • Elkhart, IN
National Provider Identifier
1164425997
Registry record updated Jul 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
01046919A Issued in IN
Practice address
303 S Nappanee St Ste a
Elkhart, IN 46514-2066
Phone
(574) 296-3466
Fax
(574) 296-3330
NPI assigned
May 24, 2005
Last updated
Jul 8, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 01046919A IN Primary

Addresses

Primary practice location

303 S Nappanee St Ste a
Elkhart, IN 46514-2066

Mailing address

3245 Health Dr Ste 100
Granger, IN 46530-1380
Phone (574) 647-1610

Other practice location 1

500 Arcade Ave Ste 400
Elkhart, IN 46514-2487
Phone (574) 522-2284

Other practice location 2

2222 Rieth Blvd Ste 104
Goshen, IN 46526-5869
Phone (574) 875-1082

Other identifiers 1

IdentifierTypeStateIssuer
200148970MedicaidIN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040501000119 IN Practitioner - Cardiovascular Disease (Cardiology) 1759379613 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Beacon Medical Group IncGroup PAC ID 1254243306, 575 clinicians

Practice addresses (Care Compare)

303 S Nappanee St a
Elkhart Cardiology
Elkhart, IN 46514-2066
Phone (574) 296-3338

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting14
Pacemaker insertion or repair1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01046919AINMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Privia Medical Group Indiana, LLC CurrentSince Jul 19, 2004 Accepting new patients
Beacon Medical Group, Inc. Cardiovascular Disease Current Accepting new patients
Beacon Medical Group Inc CurrentSince Jan 1, 2014 Accepting new patients
Privia Medical Group Indiana, LLC Current Accepting new patients
Beacon Medical Group, Inc. Cardiovascular Disease CurrentSince Jan 1, 2014 Accepting new patients
Privia Medical Group Indiana, LLC CurrentSince Jul 19, 2004 Accepting new patients
Elkhart General Hospital, Inc. Past Accepting new patients
Heart Center of Lake County,P.C. Cardiovascular Disease Past Accepting new patients

Locations

25651 County Road 20
Elkhart, IN 46517
Phone (219) 522-1201

303 S Nappanee St
Elkhart, IN 46514

303 S Nappanee St
#A
Elkhart, IN 46514
Phone (574) 296-3338

303 S Nappanee St
Ste A
Elkhart, IN 46514
Phone (574) 296-3338

3245 Health Dr
Ste 100
Granger, IN 46530
Phone (574) 647-2129

6913 N Main St
Granger, IN 46530
Phone (574) 647-1500

4630 Vistula Rd
Mishawaka, IN 46544
Phone (219) 254-7200

710 N Niles Ave
South Bend, IN 46617
Phone (574) 647-1610

Interoperability endpoints

  • Direct secure messaging: luisitogonzales@beacon.allscriptsdirect.net

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

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": "1116892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783468800000",
    "number": "1164425997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3245 HEALTH DR STE 100",
            "city": "GRANGER",
            "state": "IN",
            "postal_code": "465301380",
            "telephone_number": "574-647-1610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 S NAPPANEE ST STE A",
            "city": "ELKHART",
            "state": "IN",
            "postal_code": "465142066",
            "telephone_number": "574-296-3466",
            "fax_number": "574-296-3330"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "500 Arcade Ave Ste 400",
            "address_purpose": "LOCATION",
            "city": "Elkhart",
            "state": "IN",
            "postal_code": "465142487",
            "country_code": "US",
            "telephone_number": "574-522-2284",
            "fax_number": "574-522-3952",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2222 Rieth Blvd Ste 104",
            "address_purpose": "LOCATION",
            "city": "Goshen",
            "state": "IN",
            "postal_code": "465265869",
            "country_code": "US",
            "telephone_number": "574-875-1082",
            "fax_number": "574-875-3860",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GONZALES",
        "first_name": "LUISITO",
        "middle_name": "C.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-24",
        "last_updated": "2026-07-08",
        "certification_date": "2026-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "IN",
            "license": "01046919A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200148970",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elkhart, IN

Sources for this page

Verify at the official NPI Registry.