Individual provider Active NPI

Cesar Emmanuel Gonzalez, PHD

  • Psychologist
  • Saint Louis, MO
National Provider Identifier
1356108534
Registry record updated Apr 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
2024007410 Issued in MO
Practice address
1044 N Mason Rd
Div Anes Pain MGT, Ste L40
Saint Louis, MO 63141-6431
Phone
(314) 747-0202
Fax
(314) 286-2675
NPI assigned
Mar 4, 2024
Last updated
Apr 17, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 2024007410 MO Primary

Addresses

Primary practice location

1044 N Mason Rd
Div Anes Pain MGT, Ste L40
Saint Louis, MO 63141-6431

Mailing address

PO Box 7412011
Chicago, IL 60674-2011
Phone (314) 747-0202

Other identifiers 1

IdentifierTypeStateIssuer
490138147MedicaidMO

Electronic endpoints 1

TypeEndpointUseAffiliation
FHIR URL https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Washington University

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240319000544 MO Practitioner - Clinical Psychologist 8820435415 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Washington UniversityGroup PAC ID 9830008770, 2,968 clinicians

Practice addresses (Care Compare)

1044 N Mason Rd
Dept Anes Pain MGT Suite L40
St Louis, MO 63141-6431
Phone (314) 747-0202

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Washington University CurrentSince Apr 1, 2024 Accepting new patients
Washington University CurrentSince Apr 1, 2024 Accepting new patients
Washington University Past Accepting new patients

Locations

1 Barnes Hsp Plz
Saint Louis, MO 63110
Phone (314) 273-4966

1044 N Mason Rd
Ste L40
Saint Louis, MO 63141
Phone (314) 747-0202

660 S Euclid Ave
#8054
Saint Louis, MO 63110
Phone (314) 286-1045

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1709510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744848000000",
    "number": "1356108534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7412011",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606742011",
            "telephone_number": "314-747-0202",
            "fax_number": "314-286-2675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1044 N MASON RD",
            "address_2": "DIV ANES PAIN MGT, STE L40",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631416431",
            "telephone_number": "314-747-0202",
            "fax_number": "314-286-2675"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "CESAR",
        "middle_name": "EMMANUEL",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-03-04",
        "last_updated": "2025-04-17",
        "certification_date": "2024-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MO",
            "license": "2024007410",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "490138147",
            "state": "MO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "Y",
            "affiliationName": "Washington University",
            "address_1": "1044 N Mason Rd",
            "address_2": "Div Anes Pain Mgt, Ste L40",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631416431",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.