Individual provider Active NPI

Maria C Gonzalez-Cerra, MD

  • Pediatrics Physician
  • Mequon, WI
National Provider Identifier
1427099589
Registry record updated Jan 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
42545 Issued in WI
Practice address
9736 N Lamplighter LN
Mequon, WI 53092-5323
Phone
(414) 358-1321
Fax
(715) 504-8758
NPI assigned
Jun 9, 2006
Last updated
Jan 13, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 13, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 42545 WI Primary

Addresses

Primary practice location

9736 N Lamplighter LN
Mequon, WI 53092-5323

Mailing address

9736 N Lamplighter LN
Mequon, WI 53092-5323
Phone (715) 612-1997

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20051019000517 WI Practitioner - Pediatric Medicine 4587680574 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
42545WIMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Aspirus Rhinelander & Tomahawk Hospitals & Clinics, Inc. CurrentSince Jan 18, 2011 Accepting new patients
Aspirus Rhinelander & Tomahawk Hospitals & Clinics, Inc. CurrentSince Jan 18, 2011 Accepting new patients

Locations

29980 Network Pl
Chicago, IL 60673

930 E Wall St
Eagle River, WI 54521
Phone (715) 477-3000

1020 Kabel Ave
Rhinelander, WI 54501
Phone (715) 361-2805

2251 N Shore Dr
Ste 100
Rhinelander, WI 54501
Phone (715) 361-3000

444 E Timber Dr
Rhinelander, WI 54501
Phone (715) 369-2300

Organizations & group practices 2

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": "1149811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736726400000",
    "number": "1427099589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9736 N LAMPLIGHTER LN",
            "city": "MEQUON",
            "state": "WI",
            "postal_code": "530925323",
            "telephone_number": "715-612-1997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9736 N LAMPLIGHTER LN",
            "city": "MEQUON",
            "state": "WI",
            "postal_code": "530925323",
            "telephone_number": "414-358-1321",
            "fax_number": "715-504-8758"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ-CERRA",
        "first_name": "MARIA",
        "middle_name": "C",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-09",
        "last_updated": "2025-01-13",
        "certification_date": "2025-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WI",
            "license": "42545",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mequon, WI

Sources for this page

Verify at the official NPI Registry.