Rosario Gonzaga, MD PA

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

D22277 Issued in MD

Legal business name

ROSARIO GONZAGA, MD PA

Practice address

957 National Hwy
Lavale, MD 21502

Phone

(301) 729-9475

Fax

(301) 729-9474

NPI assigned

Mar 28, 2013

Reactivated

Oct 30, 2019

Organization subpart

No

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

Authorized official

Name

Rommel Gonzaga

Title

Ceo

Phone

(301) 729-9475

Specialties & licenses 2

Addresses

Other names 1

• Gonzaga Pediatrics and Family Medicine Doing business as

Medicare fee-for-service enrollment

Enrolled in MD

Enrollment records 1

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/14297/brand/1/csg/1/fhir/r4

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Rosario Gonzaga, MD

  • Pediatrics Physician
  • Lavale, MD
  • NPI 1184627457
  Medicare reassignment NPD
• Daisy Amadi Muga, PA

  • Medical Physician Assistant
  • Pittsburgh, PA
  • NPI 1558019992

  MD

  Medicare reassignment

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

{
    "created_epoch": "1364428800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692230400000",
    "number": "1356684302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "957 NATIONAL HWY",
            "city": "LAVALE",
            "state": "MD",
            "postal_code": "21502",
            "telephone_number": "301-729-9475",
            "fax_number": "301-729-9474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "957 NATIONAL HWY",
            "city": "LAVALE",
            "state": "MD",
            "postal_code": "21502",
            "telephone_number": "301-729-9475",
            "fax_number": "301-729-9474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROSARIO GONZAGA, MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-03-28",
        "last_updated": "2023-08-17",
        "certification_date": "2023-08-17",
        "deactivation_date": "2019-10-21",
        "reactivation_date": "2019-10-30",
        "status": "A",
        "authorized_official_last_name": "GONZAGA",
        "authorized_official_first_name": "ROMMEL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "301-729-9475"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "MD",
            "license": "D39811",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": "MD",
            "license": "D22277",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gonzaga Pediatrics and Family Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Bethany Rhodes, LPN
• Karen Marie Rhodes, LPN
• Mary Ann Riley, D.O.
• Haley Hixon Rodeheaver, AUD
• Diana Roderick
• Evelyn Virginia Rowland, PHARM.D.
• Thomas S. Ruppert, O.D.
• Valerie Anne Ryan, DDS
• Aimee Saville, PHARMD
• Amy Schwab Owens, MS, LCPC

• Pediatrics Physician in Lavale, MD
• Providers in Lavale, MD by specialty
• Pediatrics Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.