Individual provider Active NPI

Isaiah Gonzalez

  • Pediatric Hematology & Oncology Physician
  • Houston, TX
National Provider Identifier
1417482712
Registry record updated Aug 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Hematology & Oncology PhysicianTaxonomy code 2080P0207X
License
U3218 Issued in TX
Practice address
6701 Fannin St Ste 1400
Houston, TX 77030-2613
Phone
(800) 226-2379
NPI assigned
Apr 24, 2017
Last updated
Aug 21, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Hematology & Oncology Physician 2080P0207X U3218 TX Primary

Addresses

Primary practice location

6701 Fannin St Ste 1400
Houston, TX 77030-2613

Mailing address

1730 E 18TH St
Apt 1D
Brooklyn, NY 11229-2151

Other practice location 1

506 6th St
New York Presbyterian Brooklyn Methodist Hospital
Brooklyn, NY 11215-3609
Phone (718) 780-3000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20190301001577 NY Order and Referring Only - Peripheral Vascular DiseasePractitioner - Peripheral Vascular Disease 1951640366

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
U3218TXMDPediatric Hematology & Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Children's Physician Group Pediatrics PastSince Jun 25, 2023 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1492992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692576000000",
    "number": "1417482712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1730 E 18TH ST",
            "address_2": "APT 1D",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112292151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6701 FANNIN ST STE 1400",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770302613",
            "telephone_number": "800-226-2379"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "506 6th St",
            "address_2": "New York Presbyterian Brooklyn Methodist Hospital",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112153609",
            "country_code": "US",
            "telephone_number": "718-780-3000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "ISAIAH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-24",
        "last_updated": "2023-08-21",
        "certification_date": "2023-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0207X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Hematology-Oncology",
            "state": "TX",
            "license": "U3218",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.