Kevin Luis Gonzalez, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

QA 06161 Issued in NJ

Practice address

158 Wyckoff Rd
Eatontown, NJ 07724-1840

Phone

(732) 544-0007

Fax

(732) 544-0008

NPI assigned

Jul 4, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Activity First Physical Therapy and Sports Medicine

  • Physical Therapist
  • Eatontown, NJ
  • NPI 1124108782
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1151971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196208000000",
    "number": "1225068158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "158 WYCKOFF RD",
            "city": "EATONTOWN",
            "state": "NJ",
            "postal_code": "077241840",
            "telephone_number": "732-544-0007",
            "fax_number": "732-544-0008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "158 WYCKOFF RD",
            "city": "EATONTOWN",
            "state": "NJ",
            "postal_code": "077241840",
            "telephone_number": "732-544-0007",
            "fax_number": "732-544-0008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "KEVIN",
        "middle_name": "LUIS",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-04",
        "last_updated": "2007-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "QA 06161",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gagandeep Gill, D.C.
• Christopher Charles Gillis, MD
• Laurie Goldman
• Linda Golub, P.A.
• Olivia Gomz, LSW
• Rachel Gonzalez, LCSW
• Steven Alan Gorcey, M.D.
• Kelly Ann Graham, MA-SLP
• Alexandra Granovsky, PHARMD
• Marissa Greco, LPC

• Physical Therapist in Eatontown, NJ
• Providers in Eatontown, NJ by specialty
• Physical Therapist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.