Individual provider Active NPI

Anter Suarez Gonzales III, M.D.

  • Pediatric Sports Medicine Physician
  • Manasquan, NJ
National Provider Identifier
1225414071
Registry record updated Jul 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Sports Medicine PhysicianTaxonomy code 2080S0010X
License
25MA11740400 Issued in NJ
Practice address
2315 Route 34
Manasquan, NJ 08736-1444
Phone
(732) 974-0404
NPI assigned
Aug 4, 2015
Last updated
Jul 12, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Family Medicine) Physician 207QS0010X 25MA11740400 NJ
Pediatric Sports Medicine Physician 2080S0010X 25MA11740400 NJ Primary

Addresses

Primary practice location

2315 Route 34
Manasquan, NJ 08736-1444

Mailing address

2315 Route 34
Manasquan, NJ 08736-1444
Phone (732) 974-0404

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20230621003451 NJ Practitioner - Sports Medicine 1658618657 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Sports Medicine
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orthonj LLCGroup PAC ID 6800225178, 302 clinicians

Practice addresses (Care Compare)

2315 Route 34
Manasquan, NJ 08736-1444
Phone (732) 974-0404

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA11740400NJMDPediatric Sports Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Orthonj LLC CurrentSince Jul 7, 2023 Accepting new patients
Orthonj LLC CurrentSince Jul 7, 2023 Accepting new patients

Locations

2315 Route 34
Manasquan, NJ 08736
Phone (732) 974-0404

Interoperability endpoints

  • Direct secure messaging: agonzales1052691@nychhc.direct-ci.com
  • Direct secure messaging: antergonzales@sunydmc.allscriptsdirect.net

Organizations & group practices 2

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 3

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": "1438646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689120000000",
    "number": "1225414071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2315 ROUTE 34",
            "city": "MANASQUAN",
            "state": "NJ",
            "postal_code": "087361444",
            "telephone_number": "732-974-0404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2315 ROUTE 34",
            "city": "MANASQUAN",
            "state": "NJ",
            "postal_code": "087361444",
            "telephone_number": "732-974-0404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALES",
        "first_name": "ANTER",
        "middle_name": "SUAREZ",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-08-04",
        "last_updated": "2023-07-12",
        "certification_date": "2023-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "NJ",
            "license": "25MA11740400",
            "primary": false
        },
        {
            "code": "2080S0010X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Sports Medicine",
            "state": "NJ",
            "license": "25MA11740400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manasquan, NJ

Sources for this page

Verify at the official NPI Registry.