Ricardo Gonzalez MD Family Practice PC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

10279 Issued in NV

Legal business name

RICARDO GONZALEZ MD FAMILY PRACTICE PC

Doing business as

Peavine Family Practice

Practice address

2005 Sierra Highlands Dr Ste 101
Reno, NV 89523-2301

Phone

(775) 624-6492

NPI assigned

Aug 16, 2017

Organization subpart

No

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

Authorized official

Name

Dr. Ricardo J. Gonzalez, MDNPI 1326011297

Title

Owner

Phone

(775) 624-6492

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Peavine Family Practice Doing business as

Medicare fee-for-service enrollment

Enrolled in NV

Enrollment records 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ricardo Juan Gonzalez, MD

  • Family Medicine Physician
  • Reno, NV
  • NPI 1326011297
  Medicare reassignment Authorized official
• Leslie Luanne Pace, APN

  • Family Nurse Practitioner
  • Reno, NV
  • NPI 1609004126
  Medicare reassignment
• Lisa Marie Tate, APN

  • Nurse Practitioner
  • Reno, NV
  • NPI 1265561021
  Medicare reassignment

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

{
    "created_epoch": "1502841600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1265958862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2005 SIERRA HIGHLANDS DR STE 101",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895232301",
            "telephone_number": "775-624-6492"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2005 SIERRA HIGHLANDS DR STE 101",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895232301",
            "telephone_number": "775-624-6492"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RICARDO GONZALEZ MD FAMILY PRACTICE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-16",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "GONZALEZ",
        "authorized_official_first_name": "RICARDO",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "775-624-6492",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "NV",
            "license": "10279",
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": "NV",
            "license": "10279",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "13216011297",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Peavine Family Practice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Susan Dianne Ribeiro, M.D.
• Deborah J Ribnick, PHD
• Martina Grace Ricafort, PT
• Ricardo Garcia MD PC
• Ricardo Garcia, MD, PC
• Peter Lawrence Ricciardi, D.D.S.
• Luann Ricco
• Stacey Renee Rice, LCSW
• Bailey Rich, MA, LADC-I
• Kim Rich, MFT

• Family Medicine Physician in Reno, NV
• Providers in Reno, NV by specialty
• Family Medicine Physician in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.