Michael JB Gonzalez, MD
Individual provider Active NPI Family Medicine Physician · Narragansett, RI
NPI 1265433908 · NPPES record last updated Apr 2, 2024
Key facts
- NPI
- 1265433908
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- MD11643 (RI)
- Practice address
- 360 Kingstown Rd
Suite 200
Narragansett, RI 02882-3239 - Phone
- (401) 783-6940
- Fax
- (401) 792-3676
- NPI assigned
- Aug 3, 2005
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 4
Hospital & facility affiliations 6
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Other, 1991
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Alaga Health LLC
Practice addresses (Care Compare)
360 Kingstown Rd
Unit 200
Narragansett, RI 02882-3258
Phone (401) 903-9992
Hospital & facility affiliations
- South County Home Health
- South County Hospital Inc
- The Miriam Hospital
- Kent County Memorial Hospital
- Newport Hospital
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal or shaving of skin growth | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in RI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050216000801 | RI | Practitioner - Family Practice | 5799737847 |
Reassigns benefits to 1 organization Practice locations: Narragansett, RI |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD11643 | RI | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lifespan Corporation | Current | Accepting new patients | |
| Alaga Health LLC | Family Medicine | Current |
Accepting new patients |
| Coastal Medical Physicians, Inc. | Current |
Accepting new patients | |
| Coastal Medical Physicians, Inc. | Family Medicine | Current |
Accepting new patients |
Locations
900 Warren Ave
Ste 401
East Providence, RI 02914
Phone (401) 330-2480
360 Kingstown Rd
Unit 200
Narragansett, RI 02882
Phone (401) 783-6940
360 Kingstown Rd
Narragansett, RI 02882
Phone (401) 783-6940
70 Kenyon Ave
Ste 215
Wakefield, RI 02879
Phone (401) 783-0084
Interoperability endpoints
- mgonzalez220857@brownhealth.medalliesdirect.net
- michael.gonzalez.1@34188.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | MD11643 | RI | Yes |
Addresses
Primary practice location
360 Kingstown Rd
Suite 200
Narragansett, RI 02882-3239
Mailing address
10 Davol SQ
Suite 400
Providence, RI 02903-4754
Phone (401) 421-4000
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 050513293 | Other | UHP |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | mgonzalez220857@direct.lifespan.org |
Other providers in Narragansett, RI
- Galilee Mission
- Hillary Elizabeth Gallagher
- Kristen R. Gangemi
- Jesse Gleckman
- Nicole Gogolin
- Morgan Gould
- Jason Charles Graff
- Monica L Gross
- Lawson Waite Gunn
- Belinda Jo Harrison
All providers in Narragansett, RI · Family Medicine Physician in Rhode Island
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 2, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.