Andrea Cristina Gonzalez, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

35.142696 Issued in OH

Practice address

1140 S Knoxville Ave Ste a
Saint Marys, OH 45885-2609

Phone

(419) 394-9959

Fax

(419) 394-0255

NPI assigned

Jul 3, 2008

Last updated

Dec 6, 2021By the provider in NPPES

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

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in AZ, OH2 enrollments

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 2

Specialty

Family Practice

Education

Wright State University Boonshoft School of Medicine, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

JTDM Family Practice LLCGroup PAC ID 2163415837, 48 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Grand Lake Home Health Home health agency, St Marys, OH, CCN 367405
• Grand Lake Health System Hospital, Saint Marys, OH, CCN 360032
• Mercer County Joint Township Community Hospital Hospital, Coldwater, OH, CCN 360058
• Otterbein St Marys Retirement Community Nursing home, St Marys, OH, CCN 365953

Merit-based Incentive Payment System (MIPS)

Final score

85.44 of 100Reported as group

Quality

78

Promoting interoperability

96

Improvement activities

40

Cost

76.79

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• JTDM Family Practice LLC

  • Family Medicine Physician
  • Saint Marys, OH
  • NPI 1184652539
  Medicare reassignment Care Compare group NPD
• Northern Arizona Healthcare Corporation

  • Family Medicine Physician
  • Flagstaff, AZ
  • NPI 1669914552
  Medicare reassignment NPD
• Flagstaff Pathology Associates

  dba Pathology Associates of Northern AZ

  • Anatomic Pathology & Clinical Pathology Physician
  • Flagstaff, AZ
  • NPI 1306205612
  NPD
• Northern Arizona Healthcare Corporation

  dba Northern Arizona Healthcare Children's Health Center

  • Multi-Specialty Clinic/Center
  • Flagstaff, AZ
  • NPI 1235732702
  NPD
• Joint Township District Memorial Hospital

  • General Acute Care Hospital
  • Saint Marys, OH
  • NPI 1639133002
  NPD (past)
• Lima Memorial Joint Operating Company

  dba Lima Memorial Health System

  • General Acute Care Hospital
  • Lima, OH
  • NPI 1336144732
  NPD (past)
• Big Park Family Practice PC

  • Family Nurse Practitioner
  • Sedona, AZ
  • NPI 1902000763
  NPD (past)
• Oracle Healthcare

  • Family Medicine Physician
  • Camp Verde, AZ
  • NPI 1396900122
  NPD (past)
• Verde Valley Medical Center

  • General Acute Care Hospital
  • Cottonwood, AZ
  • NPI 1346291648
  NPD (past)

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

• Joint Township District Memorial Hospital

  • General Acute Care Hospital
  • Saint Marys, OH
  • NPI 1639133002
  Care Compare affiliation
• Joint Township District Memorial Hospital

  dba Grand Lake Home Health

  • Home Health Agency
  • Saint Marys, OH
  • NPI 1811951817
  Care Compare affiliation
• Mercer County Joint Township Community Hospital

  dba Mercer Health

  • General Acute Care Hospital
  • Coldwater, OH
  • NPI 1497784144
  Care Compare affiliation
• Otterbein St. Marys

  • Skilled Nursing Facility
  • Saint Marys, OH
  • NPI 1801888235

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1215043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638748800000",
    "number": "1437312147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1140 S KNOXVILLE AVE STE D",
            "city": "SAINT MARYS",
            "state": "OH",
            "postal_code": "458852609",
            "telephone_number": "419-300-1129",
            "fax_number": "419-394-0255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1140 S KNOXVILLE AVE STE A",
            "city": "SAINT MARYS",
            "state": "OH",
            "postal_code": "458852609",
            "telephone_number": "419-394-9959",
            "fax_number": "419-394-0255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "ANDREA",
        "middle_name": "CRISTINA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-03",
        "last_updated": "2021-12-06",
        "certification_date": "2021-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35.142696",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0455916",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "andreagonzalez@glhs.allscriptsdirect.net",
            "affiliation": "N",
            "address_1": "1140 S Knoxville Ave Ste A",
            "city": "Saint Marys",
            "state": "OH",
            "country_code": "US",
            "postal_code": "458852609",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kenneth L Fox, MD
• Connie Lynn Friemering, M.A.CCC/SLP
• Claire Christine Gabel
• Stacy Jo Glass
• Janeva Joan Golembiewski
• Garnett Rana Goodwin
• Kristen Gower
• Grand Lake Operations (Vancrest of St Marys)
• Grand Lake Operations, LLC
• Grand Lake Sleep Center

• Family Medicine Physician in Saint Marys, OH
• Providers in Saint Marys, OH by specialty
• Family Medicine Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 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.