Mailyn Gonzalez, PA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

25MP00285500 Issued in NJ

Practice address

201 Route 17 North
5TH Floor
Rutherford, NJ 07070

Phone

(201) 457-0044

Fax

(201) 457-0049

NPI assigned

Jul 2, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Kayal Medical Group, LLCGroup PAC ID 2961894019, 76 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Hackensack Meridian Health Pascack Valley Medical Hospital, Westwood, NJ, CCN 310130

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: mgonzalez864043@ahs.direct-ci.com

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.

• Kayal Medical Group, LLC

  • Orthopaedic Surgery Physician
  • Franklin Lakes, NJ
  • NPI 1528729159
  Medicare reassignment Care Compare group
• Kayal Orthopaedic Center, P.C.

  • Orthopaedic Surgery Physician
  • Franklin Lakes, NJ
  • NPI 1427014083
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Pascack Valley Hospital LLC

  • General Acute Care Hospital
  • Westwood, NJ
  • NPI 1205176062
  Care Compare affiliation

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

{
    "created_epoch": "1341187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536624000000",
    "number": "1295099505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 ROUTE 17 NORTH",
            "address_2": "5TH FLOOR",
            "city": "RUTHERFORD",
            "state": "NJ",
            "postal_code": "07070",
            "telephone_number": "201-457-0044",
            "fax_number": "201-457-0049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 ROUTE 17 NORTH",
            "address_2": "5TH FLOOR",
            "city": "RUTHERFORD",
            "state": "NJ",
            "postal_code": "07070",
            "telephone_number": "201-457-0044",
            "fax_number": "201-457-0049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "MAILYN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-02",
        "last_updated": "2018-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NJ",
            "license": "25MP00285500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Gilch Pesantez, PSY. D.
• Zuri Gill
• Adriana Girard, PA-C
• Global Passport, Inc
• Eleanor A Gonnella, MD
• Robert Ceris Graber, D.M.D.
• Santo Vincent Grasso Jr., D.O.
• Ashley Alden Grey, BCBA, M.A
• Alison R Grolli
• Damaris Grossmann, APRN, DNP , FNP-C

• Surgical Physician Assistant in Rutherford, NJ
• Providers in Rutherford, NJ by specialty
• Surgical Physician Assistant in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.