Active NPI
Jose Luis Gonzales, CO,BOCO
- Orthotist
- Mequon, WI
National Provider Identifier
1235607011
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthotist
- Practice address
- 12075 Corporate Pkwy Ste 120
Mequon, WI 53092-2664 - Phone
- (262) 643-4418
- NPI assigned
- Nov 9, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthotist | 222Z00000X | Primary |
Addresses
Primary practice location
12075 Corporate Pkwy Ste 120
Mequon, WI 53092-2664
Mailing address
20225 Sutter Creek Dr Apt 208
Brookfield, WI 53045-3931
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cranial Technologies Inc. | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Prosthetic/Orthotic Supplier
- Milwaukee, WI
- NPI 1134507429
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1541721600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1541721600000",
"number": "1235607011",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20225 SUTTER CREEK DR APT 208",
"city": "BROOKFIELD",
"state": "WI",
"postal_code": "530453931"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12075 CORPORATE PKWY STE 120",
"city": "MEQUON",
"state": "WI",
"postal_code": "530922664",
"telephone_number": "262-643-4418"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GONZALES",
"first_name": "JOSE",
"middle_name": "LUIS",
"credential": "CO,BOCO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-11-09",
"last_updated": "2018-11-09",
"status": "A"
},
"taxonomies": [
{
"code": "222Z00000X",
"taxonomy_group": "",
"desc": "Orthotist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mequon, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.