Active NPI
Juan A. Asensio-Gonzalez, M.D., FACS, FCCM, FR
- Trauma Surgery Physician
- Myrtle Beach, SC
National Provider Identifier
1295793149
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Trauma Surgery Physician
- License
- 91224
- Practice address
- 920 Doug White Dr Ste 210
Myrtle Beach, SC 29572-4181 - Phone
- (843) 497-6348
- Fax
- (843) 497-6351
- NPI assigned
- May 2, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 6
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgical Critical Care Physician | 2086S0102X | 72444 | GA | |
| Trauma Surgery Physician | 2086S0127X | 264501 | NY | |
| Trauma Surgery Physician | 2086S0127X | 28147 | NE | |
| Trauma Surgery Physician | 2086S0127X | ME95504 | FL | |
| Trauma Surgery Physician | 2086S0127X | 91224 | SC | Primary |
| Surgical Critical Care Physician | 2086S0102X | 91224 | SC |
Addresses
Primary practice location
920 Doug White Dr Ste 210
Myrtle Beach, SC 29572-4181
Mailing address
920 Doug White Dr Ste 210
Myrtle Beach, SC 29572-4181
Phone (843) 497-6348
Other practice location 1
305 W Jackson St Ste 302
Carbondale, IL 62901-1474
Phone (618) 457-3006
Other practice location 2
601 N 30th St
Suite 3700
Omaha, NE 68131-2128
Phone (402) 717-4909
Other practice location 3
1211 Sherwood Park Dr NE Ste A
Gainesville, GA 30501-3444
Phone (770) 219-3202
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01168327 | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Alegent Creighton Clinic | Past | Accepting new patients |
Interoperability endpoints
- juan.asensiogonzalez@hca5.eclinicaldirectplus.com
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.
-
- Family Medicine Physician
- Council Bluffs, IA
- NPI 1598811069
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146528000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1710288000000",
"number": "1295793149",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "920 DOUG WHITE DR STE 210",
"city": "MYRTLE BEACH",
"state": "SC",
"postal_code": "295724181",
"telephone_number": "843-497-6348",
"fax_number": "843-497-6351"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "920 DOUG WHITE DR STE 210",
"city": "MYRTLE BEACH",
"state": "SC",
"postal_code": "295724181",
"telephone_number": "843-497-6348",
"fax_number": "843-497-6351"
}
],
"practiceLocations": [
{
"address_1": "305 W Jackson St Ste 302",
"address_purpose": "LOCATION",
"city": "Carbondale",
"state": "IL",
"postal_code": "629011474",
"country_code": "US",
"telephone_number": "618-457-3006",
"fax_number": "618-457-3007",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "601 N 30th St",
"address_2": "Suite 3700",
"address_purpose": "LOCATION",
"city": "Omaha",
"state": "NE",
"postal_code": "681312128",
"country_code": "US",
"telephone_number": "402-717-4909",
"fax_number": "402-717-6062",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1211 Sherwood Park Dr NE Ste A",
"address_purpose": "LOCATION",
"city": "Gainesville",
"state": "GA",
"postal_code": "305013444",
"country_code": "US",
"telephone_number": "770-219-3202",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ASENSIO-GONZALEZ",
"first_name": "JUAN",
"middle_name": "A.",
"name_prefix": "Dr.",
"credential": "M.D., FACS, FCCM, FR",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-02",
"last_updated": "2024-03-13",
"certification_date": "2024-03-13",
"status": "A"
},
"taxonomies": [
{
"code": "2086S0102X",
"taxonomy_group": "",
"desc": "Surgery, Surgical Critical Care",
"state": "GA",
"license": "72444",
"primary": false
},
{
"code": "2086S0127X",
"taxonomy_group": "",
"desc": "Surgery, Trauma Surgery",
"state": "NY",
"license": "264501",
"primary": false
},
{
"code": "2086S0127X",
"taxonomy_group": "",
"desc": "Surgery, Trauma Surgery",
"state": "NE",
"license": "28147",
"primary": false
},
{
"code": "2086S0127X",
"taxonomy_group": "",
"desc": "Surgery, Trauma Surgery",
"state": "FL",
"license": "ME95504",
"primary": false
},
{
"code": "2086S0127X",
"taxonomy_group": "",
"desc": "Surgery, Trauma Surgery",
"state": "SC",
"license": "91224",
"primary": true
},
{
"code": "2086S0102X",
"taxonomy_group": "",
"desc": "Surgery, Surgical Critical Care",
"state": "SC",
"license": "91224",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01168327",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Myrtle Beach, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.