Mkiyah Teleza Gonzalez, N.P

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

0024168968 Issued in VA

Practice address

1129 Heatherstone Dr
Fredericksburg, VA 22407-4828

Phone

(540) 785-8500

Fax

(540) 785-5328

NPI assigned

Sep 27, 2011

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Mikyah Teleza Grant Former name

Medicare fee-for-service enrollment

Enrolled in VA

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Fredericksburg Christian Health CenterGroup PAC ID 5890887962, 7 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mary Washington Hospital Hospital, Fredericksburg, VA, CCN 490022

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mgonzalez36784@marywashingtonhealthcare.direct-ci.com

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.

• Fredericksburg Christian Health Center

  • Family Medicine Physician
  • Fredericksburg, VA
  • NPI 1639222359
  Medicare reassignment Care Compare group NPD

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

• Mary Washington Hospital Inc.

  • General Acute Care Hospital
  • Fredericksburg, VA
  • NPI 1942288527
  Care Compare affiliation
• Mary Washington Hospital, Inc.

  • Cardiovascular Disease Physician
  • Fredericksburg, VA
  • NPI 1013089879

  Hospital

  Care Compare affiliation
• Mary Washington Hospital, Inc.

  • Home Health Agency
  • Fredericksburg, VA
  • NPI 1407814163

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1317081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317081600000",
    "number": "1376826248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1129 HEATHERSTONE DR",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224074828",
            "telephone_number": "540-785-8500",
            "fax_number": "540-785-5328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1129 HEATHERSTONE DR",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224074828",
            "telephone_number": "540-785-8500",
            "fax_number": "540-785-5328"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "MKIYAH",
        "middle_name": "TELEZA",
        "credential": "N.P",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-09-27",
        "last_updated": "2011-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024168968",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MIKYAH",
            "last_name": "GRANT",
            "middle_name": "TELEZA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Irma Gonzalez Medrano, RBT
• Conrado C Gonzalez Jr., MD
• Evan Gonzalez, PA-C
• Jonathan Kenneth Gonzalez, MD
• Luz Amalya Gonzalez, CSAC, RESIDENT IN CO
• Odalys Gonzalez, FNP
• Hunter Carlisle Goode, RPH
• Allison H Goodlett, M.D.
• Charles Alexander Goodwin, PT
• Stephanie Elaine Goodwin, MA, CSAC, QMHP

• Family Nurse Practitioner in Fredericksburg, VA
• Providers in Fredericksburg, VA by specialty
• Family Nurse Practitioner in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2011; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.