Federico Gonzalez, MD

Primary specialty

Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X

License

0426273 Issued in KS

Practice address

23351 Prairie Star Pkwy Ste 125
Lenexa, KS 66227-6201

Phone

(913) 676-8626

Fax

(913) 676-8649

NPI assigned

Nov 8, 2005

Reactivated

Oct 31, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Shawnee Mission Medical Center, Inc.

  • Radiology Clinic/Center
  • Roeland Park, KS
  • NPI 1578178521
  NPD (past)

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

{
    "created_epoch": "1131408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638748800000",
    "number": "1376524298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 N PARKER ST # 284",
            "city": "OLATHE",
            "state": "KS",
            "postal_code": "660613139",
            "telephone_number": "913-660-4742",
            "fax_number": "913-204-1329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23351 PRAIRIE STAR PKWY STE 125",
            "city": "LENEXA",
            "state": "KS",
            "postal_code": "662276201",
            "telephone_number": "913-676-8626",
            "fax_number": "913-676-8649"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "FEDERICO",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-08",
        "last_updated": "2021-12-06",
        "certification_date": "2021-12-06",
        "deactivation_date": "2005-11-08",
        "reactivation_date": "2006-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "KS",
            "license": "0426273",
            "primary": true
        },
        {
            "code": "2086S0105X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgery of the Hand",
            "state": "KS",
            "license": "0426273",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100141250C",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UHC",
            "identifier": "1300066",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4346992",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KANSAS LICENSE",
            "identifier": "04-26273",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "18975138",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Allison Gochenour
• Lindsay Goens, RN
• Meghan Grace Goff, MPAS, PA-C
• Afton L Golub, FNP-C
• Brittney Gonzalez
• Goodlife Innovations Inc.
• Jana L Goolsby, PTA
• Lauren Michelle Gordon, PHARMD
• Julie A Gorenc, CNM
• Margaret Goza

• Plastic and Reconstructive Surgery Physician in Lenexa, KS
• Providers in Lenexa, KS by specialty
• Plastic and Reconstructive Surgery Physician in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.