Individual provider Active NPI

Ricardo J. Gonzalez, M.D.

  • Surgical Oncology Physician
  • Tampa, FL
National Provider Identifier
1275632929
Registry record updated Mar 26, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Oncology PhysicianTaxonomy code 2086X0206X
License
ME102674 Issued in FL
Practice address
12902 Magnolia Dr.
Fob-1
Tampa, FL 33612
Phone
(813) 745-6161
NPI assigned
Sep 21, 2006
Last updated
Mar 26, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Oncology Physician 2086X0206X ME102674 FL Primary

Addresses

Primary practice location

12902 Magnolia Dr.
Fob-1
Tampa, FL 33612

Mailing address

12902 Magnolia Dr.
Fob-1
Tampa, FL 33612
Phone (813) 745-6161

Other identifiers 1

IdentifierTypeStateIssuer
000130200MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080926000574 FL Practitioner - General Surgery 0446299564 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
University of South Florida College of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

12902 Usf Magnolia Dr
Tampa, FL 33612-9416
Phone (888) 860-2778

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88 of 100Reported as group
Quality
74.04
Promoting interoperability
100
Improvement activities
40
Cost
70.96

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision27
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME102674FLMDSurgical Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
H Lee Moffitt Cancer Ctr & Res Inst Life Time Cancer SCRN Ctr Inc Surgical Oncology CurrentSince Oct 1, 2008 Accepting new patients

Locations

12902 Usf Magnolia Dr
Tampa, FL 33612
Phone (813) 745-2720

Interoperability endpoints

  • Direct secure messaging: ricardo.gonzalez@direct.moffitt.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1364256000000",
    "number": "1275632929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12902 MAGNOLIA DR.",
            "address_2": "FOB-1",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "33612",
            "telephone_number": "813-745-6161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12902 MAGNOLIA DR.",
            "address_2": "FOB-1",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "33612",
            "telephone_number": "813-745-6161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "RICARDO",
        "middle_name": "J.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-21",
        "last_updated": "2013-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086X0206X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Oncology",
            "state": "FL",
            "license": "ME102674",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000130200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.