Individual provider Active NPI

Juan Alberto Gonzalez, D.P.M.

  • Podiatrist
  • El Paso, TX
National Provider Identifier
1245266170
Registry record updated Dec 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
1282 Issued in TX
Practice address
1501 N Mesa St
Suite 104
El Paso, TX 79902-4046
Phone
(915) 577-0744
Fax
(915) 577-0271
NPI assigned
Jun 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 1282 TX Primary

Addresses

Primary practice location

1501 N Mesa St
Suite 104
El Paso, TX 79902-4046

Mailing address

5959 Gateway Blvd W
Ste 120
El Paso, TX 79925-3331
Phone (915) 779-1716

Other identifiers 1

IdentifierTypeStateIssuer
109394001MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101117000570 TX Practitioner - Podiatry 6800790064 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Kent State University College of Podiatric Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

6330 N Mesa St
Suite F
El Paso, TX 79912-4572
Phone (915) 577-0744

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue18
Removal of nail tissue27

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Foot Specialists of El Paso Podiatrist CurrentSince Mar 1, 1995 Accepting new patients

Locations

202 N 2nd St
Alpine, TX 79830
Phone (432) 837-5505

6559 N Mesa St
El Paso, TX 79912
Phone (915) 584-5683

1501 N Mesa St
Ste 104
El Paso, TX 79902

1501 Arizona Ave
Ste 15A
El Paso, TX 79902

1700 N Oregon St
Ste 630
El Paso, TX 79902
Phone (915) 225-0410

5959 Gateway Blvd W
Ste 120
El Paso, TX 79925

6559 N Mesa St
Ste 2
El Paso, TX 79912

6330 N Mesa St
Ste F
El Paso, TX 79912

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.

NPI Registry JSON

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

{
    "created_epoch": "1151020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1229385600000",
    "number": "1245266170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5959 GATEWAY BLVD W",
            "address_2": "STE 120",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799253331",
            "telephone_number": "915-779-1716",
            "fax_number": "915-779-1754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 N MESA ST",
            "address_2": "SUITE 104",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799024046",
            "telephone_number": "915-577-0744",
            "fax_number": "915-577-0271"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "JUAN",
        "middle_name": "ALBERTO",
        "name_prefix": "Mr.",
        "credential": "D.P.M.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-23",
        "last_updated": "2008-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "TX",
            "license": "1282",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "109394001",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in El Paso, TX

Sources for this page

Verify at the official NPI Registry.