Active NPI
Leoncio G Gonzalez, MD
- General Practice Physician
- Dover, NJ
National Provider Identifier
1366617987
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Physician
- License
- 25MA04600100
- Practice address
- 400 W Blackwell St
St Clares Hospital
Dover, NJ 07801 - Phone
- (973) 927-6519
- NPI assigned
- Apr 24, 2008
- 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 |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | 25MA04600100 | NJ | Primary |
Addresses
Primary practice location
400 W Blackwell St
St Clares Hospital
Dover, NJ 07801
Mailing address
91 Pleasant Hill Rd
Randolph, NJ 07869
Phone (973) 927-6519
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)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25MA04600100 | NJ | MD | General Practice Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1208995200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1208995200000",
"number": "1366617987",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "91 PLEASANT HILL RD",
"city": "RANDOLPH",
"state": "NJ",
"postal_code": "07869",
"telephone_number": "973-927-6519"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "400 W BLACKWELL ST",
"address_2": "ST CLARES HOSPITAL",
"city": "DOVER",
"state": "NJ",
"postal_code": "07801",
"telephone_number": "973-927-6519"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GONZALEZ",
"first_name": "LEONCIO",
"middle_name": "G",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-04-24",
"last_updated": "2008-04-24",
"status": "A"
},
"taxonomies": [
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "NJ",
"license": "25MA04600100",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dover, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.