Individual provider Active NPI

Robert Gonzalez, M.D.

  • Psychiatry Physician
  • Harrisburg, PA
National Provider Identifier
1194962845
Registry record updated Apr 18, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
MD463082 Issued in PA
Practice address
2501 N 3Rd St
Harrisburg, PA 17110-1904
Phone
(717) 782-4734
Fax
(717) 782-4727
NPI assigned
Jan 16, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X MD463082 PA Primary
Psychiatry Physician 2084P0800X M7220 TX

Addresses

Primary practice location

2501 N 3Rd St
Harrisburg, PA 17110-1904

Mailing address

PO Box 858
MC A410
Hershey, PA 17033-0858
Phone (800) 243-1455

Other identifiers 2

IdentifierTypeStateIssuer
103449986MedicaidPA
620740OtherPAMEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, MA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20100428000220 TX Practitioner - Psychiatry 5890822696 Reassigns benefits to 1 organization
I20230809001708 MA Practitioner - Psychiatry 5890822696 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
University of Texas Southwestern Medical School at Dallas, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Brigham and Womens Physicians Organization IncGroup PAC ID 3870405988, 2,931 clinicians

Practice addresses (Care Compare)

75 Francis St
Boston, MA 02115-6110
Phone (617) 732-5500

Hospital & facility affiliations

  • Brigham and Women'S Hospital Hospital, Boston, MA, CCN 220110

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD463082PAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Brigham & Womens Physicians Organization Inc CurrentSince Jun 27, 2023 Accepting new patients
Texas Tech University Health Sciences Center El Paso CurrentSince Aug 24, 2013 Accepting new patients
Texas Tech University Health Sciences Center El Paso Current Accepting new patients
Brigham & Womens Hospital, Inc. CurrentSince Jun 27, 2023 Accepting new patients
Brigham and Women'S Hospital Current Accepting new patients
Texas Tech University Health Sciences Center El Paso Psychiatry CurrentSince Aug 24, 2013 Accepting new patients

Locations

221 Longwood Ave
Boston, MA 02115
Phone (617) 732-4918

75 Francis St
Boston, MA 02115

254 2nd Ave
Ste 100
Needham Heights, MA 02494
Phone (781) 416-8412

399 Revolution Dr
Somerville, MA 02145
Phone (800) 856-1983

4801 Alberta Ave
El Paso, TX 79905
Phone (915) 215-5200

4615 Alameda Ave
El Paso, TX 79905
Phone (432) 268-7247

4800 Alberta Ave
#101
El Paso, TX 79905
Phone (915) 215-4478

Interoperability endpoints

  • Direct secure messaging: gonzalez.robert.bwh@direct.partners.masshiway.net

Organizations & group practices 6

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 1

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": "1232064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524009600000",
    "number": "1194962845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 858",
            "address_2": "MC A410",
            "city": "HERSHEY",
            "state": "PA",
            "postal_code": "170330858",
            "telephone_number": "800-243-1455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2501 N 3RD ST",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171101904",
            "telephone_number": "717-782-4734",
            "fax_number": "717-782-4727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-01-16",
        "last_updated": "2018-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "PA",
            "license": "MD463082",
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "TX",
            "license": "M7220",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103449986",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "620740",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Harrisburg, PA

Sources for this page

Verify at the official NPI Registry.