Marilou Marcelo Gonzalez, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

M-13052 Issued in ID

Practice address

Mairmn Health
427 N. 12TH Street
Plummer, ID 83851

Phone

(208) 686-1931

Fax

(208) 686-5133

NPI assigned

Jun 8, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ID

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

Specialty

General Practice

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Benewah Medical CenterGroup PAC ID 6709878622, 27 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Centerwell Home Health Home health agency, Coeur D'Alene, ID, CCN 137112
• Kootenai Health Hospital, Coeur D'Alene, ID, CCN 130049
• Benewah Community Hospital Hospital, Saint Maries, ID, CCN 131317

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mgonzalez812456@direct.ochin.org

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.

• Benewah Medical Center

  • Federally Qualified Health Center (FQHC)
  • Plummer, ID
  • NPI 1336135136
  Medicare reassignment Care Compare group NPD

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

• Benewah Community Hospital

  • Critical Access Hospital
  • St Maries, ID
  • NPI 1548320435
  Care Compare affiliation
• Centerwell Certified Healthcare Corp.

  • Home Health Agency
  • Coeur D Alene, ID
  • NPI 1639109762
  Care Compare affiliation
• Kootenai Health, Inc.

  • General Acute Care Hospital
  • Coeur D Alene, ID
  • NPI 1992798409
  Care Compare affiliation

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

{
    "created_epoch": "1275955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637712000000",
    "number": "1376863712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 388",
            "address_2": "427 N. 12TH STREET",
            "city": "PLUMMER",
            "state": "ID",
            "postal_code": "83851",
            "telephone_number": "208-686-1931",
            "fax_number": "208-686-0213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MAIRMN HEALTH",
            "address_2": "427 N. 12TH STREET",
            "city": "PLUMMER",
            "state": "ID",
            "postal_code": "83851",
            "telephone_number": "208-686-1931",
            "fax_number": "208-686-5133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "MARILOU",
        "middle_name": "MARCELO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-08",
        "last_updated": "2021-11-24",
        "certification_date": "2021-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ID",
            "license": "M-13052",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chase Albert Francoeur, OD
• Coy Fullen, DO
• Laura Gallaher, LCSW
• Evie L Gardipe
• Natasha Goddard
• Joy Katherine Goodwin, PA-C
• Judy Rae Gordon, RN
• Terry B Hale, DDS
• Katelyn Hammrich, PA
• Chanda Mae Heer, RN

• Family Medicine Physician in Plummer, ID
• Providers in Plummer, ID by specialty
• Family Medicine Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 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.
• 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.