Individual provider Active NPI

Patrick M. Gonzalez, M.D.

  • Physical Medicine & Rehabilitation Physician
  • Port St Lucie, FL
National Provider Identifier
1447364534
Registry record updated Jun 22, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
ME 67553 Issued in FL
Practice address
1420 SW Saint Lucie West Blvd
Suite 102
Port St Lucie, FL 34986-1709
Phone
(772) 873-1005
Fax
(772) 873-9106
NPI assigned
Aug 18, 2006
Last updated
Jun 22, 2010By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 22, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X ME 67553 FL Primary

Addresses

Primary practice location

1420 SW Saint Lucie West Blvd
Suite 102
Port St Lucie, FL 34986-1709

Mailing address

1420 SW Saint Lucie West Blvd
Suite 102
Port St Lucie, FL 34986-1709
Phone (772) 873-1005

Other identifiers 2

IdentifierTypeStateIssuer
377982300MedicaidFL
59-3362726OtherFLEMPLOYER INDENTIF. NUMBER

Other names 1

  • Patrick M. Gonzalez-Ramil Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20100831000214 FL Practitioner - Physical Medicine and Rehabilitation 2961526710 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
University Central del Caribe Escuela de Medicina, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1420 SW Saint Lucie W Blvd
Suite 102
Port Saint Lucie, FL 34986-1709
Phone (772) 873-1005

Merit-based Incentive Payment System (MIPS)

Final score
73.12 of 100Reported as individual
Quality
51.67
Promoting interoperability
99
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME 67553FLMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Patrick M. Gonzalez, M.D., P.a. Physical Medicine & Rehabilitation CurrentSince Jun 2, 2010 Accepting new patients
Treasure Coast Neurology West, LLC PastSince Jun 2, 2010 Accepting new patients

Locations

1420 SW Saint Lucie West Blvd
Ste 102
Saint Lucie West, FL 34986
Phone (772) 873-1005

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

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": "1155859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277164800000",
    "number": "1447364534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1420 SW SAINT LUCIE WEST BLVD",
            "address_2": "SUITE 102",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349861709",
            "telephone_number": "772-873-1005",
            "fax_number": "772-873-9106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1420 SW SAINT LUCIE WEST BLVD",
            "address_2": "SUITE 102",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349861709",
            "telephone_number": "772-873-1005",
            "fax_number": "772-873-9106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "PATRICK",
        "middle_name": "M.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-18",
        "last_updated": "2010-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "FL",
            "license": "ME 67553",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "377982300",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EMPLOYER INDENTIF. NUMBER",
            "identifier": "59-3362726",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PATRICK",
            "last_name": "GONZALEZ-RAMIL",
            "middle_name": "M.",
            "credential": "M.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Port St Lucie, FL

Sources for this page

Verify at the official NPI Registry.