Active NPI
Guillermo Gonzalez, MD
- Psychiatry Physician
- New Bedford, MA
National Provider Identifier
1316948367
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 59703
- Practice address
- 196 Union St
New Bedford, MA 02740-5942 - Phone
- (508) 990-4963
- Fax
- (508) 990-4964
- NPI assigned
- Aug 2, 2005
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 59703 | MA | Primary |
Addresses
Primary practice location
196 Union St
New Bedford, MA 02740-5942
Mailing address
PO Box 3021
New Bedford, MA 02741-3021
Phone (508) 990-4963
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003490 | Other | MA | BEACON |
| 110055741A | Medicaid | MA | |
| 3137988 | Medicaid | MA |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1122940800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1317686400000",
"number": "1316948367",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 3021",
"city": "NEW BEDFORD",
"state": "MA",
"postal_code": "027413021",
"telephone_number": "508-990-4963",
"fax_number": "508-990-4964"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "196 UNION ST",
"city": "NEW BEDFORD",
"state": "MA",
"postal_code": "027405942",
"telephone_number": "508-990-4963",
"fax_number": "508-990-4964"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GONZALEZ",
"first_name": "GUILLERMO",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-08-02",
"last_updated": "2011-10-04",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "MA",
"license": "59703",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BEACON",
"identifier": "1003490",
"state": "MA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "110055741A",
"state": "MA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3137988",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in New Bedford, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.