Individual provider Active NPI

Alfredo V Gonzalez, M.D.

  • Family Medicine Physician
  • Pharr, TX
National Provider Identifier
1376593905
Registry record updated Mar 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
K8757 Issued in TX
Practice address
1301 W Sam Houston Blvd Unit a
Pharr, TX 78577-5669
Phone
(956) 702-3600
Fax
(956) 702-3606
NPI assigned
May 12, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 10, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X K8757 TX Primary

Addresses

Primary practice location

1301 W Sam Houston Blvd Unit a
Pharr, TX 78577-5669

Mailing address

1301 W Sam Houston Blvd Unit a
Pharr, TX 78577-5669
Phone (956) 702-3600

Other identifiers 1

IdentifierTypeStateIssuer
160945501MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090512000549 TX Practitioner - Family Practice 5890744296 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1301 W Sam Houston Blvd
Unit a
Pharr, TX 78577-5669
Phone (956) 702-3600

Hospital & facility affiliations

  • Doctors Hosptal at Renaissance Hospital, Edinburg, TX, CCN 450869

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
K8757TXMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Luna Pediatric and Family Clinic, LLC Family Medicine Current Accepting new patients
Luna Pediatric and Family Clinic, LLC Current Accepting new patients
Alfredo V. Gonzalez, M.D.,P.a. Legal Medicine CurrentSince Oct 1, 2003 Accepting new patients

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 and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1147392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583798400000",
    "number": "1376593905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 W SAM HOUSTON BLVD UNIT A",
            "city": "PHARR",
            "state": "TX",
            "postal_code": "785775669",
            "telephone_number": "956-702-3600",
            "fax_number": "956-702-3606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 W SAM HOUSTON BLVD UNIT A",
            "city": "PHARR",
            "state": "TX",
            "postal_code": "785775669",
            "telephone_number": "956-702-3600",
            "fax_number": "956-702-3606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "ALFREDO",
        "middle_name": "V",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-12",
        "last_updated": "2020-03-10",
        "certification_date": "2020-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "K8757",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "160945501",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pharr, TX

Sources for this page

Verify at the official NPI Registry.