Individual provider Active NPI

Ingrid Gonzalez, M.D.

  • Gastroenterology Physician
  • Winston Salem, NC
National Provider Identifier
1205034147
Registry record updated Aug 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
2012-01039 Issued in NC
Practice address
195 Kimel Park Dr Ste 200
Winston Salem, NC 27103-6967
Phone
(336) 768-6211
Fax
(336) 768-6869
NPI assigned
Jul 3, 2007
Last updated
Aug 8, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 2012-01039 NC Primary

Addresses

Primary practice location

195 Kimel Park Dr Ste 200
Winston Salem, NC 27103-6967

Mailing address

2025 Frontis Plaza Blvd
Suite 200
Winston Salem, NC 27103-5663
Phone (336) 768-6211

Other identifiers 1

IdentifierTypeStateIssuer
5920602MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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 1

Enrollment IDStateProvider typePAC IDDetails
I20120702000448 NC Practitioner - GastroenterologyPractitioner - Internal Medicine 1951472596 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
GastroenterologyAlso: Internal Medicine
Education
Icahn School of Medicine at Mount Sinai, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Digestive Health Specialists PAGroup PAC ID 6507849601, 26 clinicians

Practice addresses (Care Compare)

195 Kimel Park Dr
Suite 200
Winston Salem, NC 27103-5663

195 Kimel Park Dr
Suite 200
Winston Salem, NC 27103-6967
Phone (336) 768-6211

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.48 of 100Reported as group
Quality
81.46
Promoting interoperability
100
Improvement activities
40
Cost
76.8

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy48
Upper gastrointestinal (GI) endoscopy for acid reflux194

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2012-01039NCMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Digestive Health Specialists, PA Gastroenterology CurrentSince Jul 16, 2012 Accepting new patients
Digestive Health Specialists, PA Gastroenterology Current Accepting new patients
Digestive Health Specialists, PA CurrentSince Jul 16, 2012 Accepting new patients

Locations

195 Kimel Park Dr
Ste 200
Winston Salem, NC 27103
Phone (336) 397-5264

2025 Frontis Plaza Blvd
Ste 200
Winston Salem, NC 27103
Phone (336) 768-6621

Interoperability endpoints

  • Direct secure messaging: igonzalez144803@direct.novanthealth.org

Organizations & group practices 3

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 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": "1183420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723075200000",
    "number": "1205034147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2025 FRONTIS PLAZA BLVD",
            "address_2": "SUITE 200",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271035663",
            "telephone_number": "336-768-6211",
            "fax_number": "336-768-6869"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "195 KIMEL PARK DR STE 200",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271036967",
            "telephone_number": "336-768-6211",
            "fax_number": "336-768-6869"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "INGRID",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-03",
        "last_updated": "2024-08-08",
        "certification_date": "2024-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NC",
            "license": "2012-01039",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5920602",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

Verify at the official NPI Registry.