Individual provider Active NPI

Carlos A Gonzalez, CAA

  • Anesthesiologist Assistant
  • Merrillville, IN
National Provider Identifier
1245039635
Registry record updated Mar 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiologist AssistantTaxonomy code 367H00000X
License
75000207 Issued in IN
Practice address
8701 Broadway
Merrillville, IN 46410-7035
Phone
(219) 738-5500
NPI assigned
Mar 10, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 10, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiologist Assistant 367H00000X 75000207 IN Primary

Addresses

Primary practice location

8701 Broadway
Merrillville, IN 46410-7035

Mailing address

730 S Clark St Apt 903
Chicago, IL 60605-1745

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250430003045 IN Practitioner - Anesthesiology Assistant 5991221186 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology Assistant
Education
Emory University School of Medicine, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anesthesia Dynamics LLCGroup PAC ID 3779832530, 883 clinicians
Redreef Anesthesia Associates Chartered Indiana LLCGroup PAC ID 7012459647, 36 clinicians

Practice addresses (Care Compare)

4411 Washington Ave
Suite 100
Evansville, IN 47714-0805
Phone (313) 637-9861

8701 Broadway
Merrillville, IN 46410-7035
Phone (888) 851-4642

Hospital & facility affiliations

  • Methodist Hospitals Inc Hospital, Gary, IN, CCN 150002

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
75000207INMDAnesthesiologist Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesia Dynamics LLC CurrentSince Mar 10, 2025 Accepting new patients
Redreef Anesthesia Associates Chartered Indiana LLC CurrentSince Mar 10, 2025 Accepting new patients

Locations

11051 Broadway
Ste B
Crown Point, IN 46307
Phone (219) 308-0193

4411 Washington Ave
Ste 100
Evansville, IN 47714
Phone (313) 637-9861

8701 Broadway
Merrillville, IN 46410
Phone (219) 738-4926

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 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": "1741564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741564800000",
    "number": "1245039635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "730 S CLARK ST APT 903",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606051745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8701 BROADWAY",
            "city": "MERRILLVILLE",
            "state": "IN",
            "postal_code": "464107035",
            "telephone_number": "219-738-5500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "CARLOS",
        "middle_name": "A",
        "credential": "CAA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-03-10",
        "last_updated": "2025-03-10",
        "certification_date": "2025-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367H00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiologist Assistant",
            "state": "IN",
            "license": "75000207",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Merrillville, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2025; 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.