Michelle Marguerite Gonzalez, APRN

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

005680 Issued in CT

Practice address

18 Clearview Dr
South Windsor, CT 06074-2230

Phone

(860) 843-2012

NPI assigned

Mar 4, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other names 1

• Michelle Marguerite Panchak Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1393891200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1457776163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 CLEARVIEW DR",
            "city": "SOUTH WINDSOR",
            "state": "CT",
            "postal_code": "060742230",
            "telephone_number": "860-593-4630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18 CLEARVIEW DR",
            "city": "SOUTH WINDSOR",
            "state": "CT",
            "postal_code": "060742230",
            "telephone_number": "860-843-2012"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "80 Seymour Street",
            "address_2": "Hartford Hospital Surgery Dept",
            "address_purpose": "LOCATION",
            "city": "Hartford",
            "state": "CT",
            "postal_code": "061025037",
            "country_code": "US",
            "telephone_number": "860-972-4670",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "MICHELLE",
        "middle_name": "MARGUERITE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-03-04",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CT",
            "license": "005680",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "CT",
            "license": "5680",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "CT",
            "license": "005680",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "CT",
            "license": "005680",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHELLE",
            "last_name": "PANCHAK",
            "middle_name": "MARGUERITE",
            "credential": "APRN",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Eric Gilbert, HIS
• Nakia M Gilbert, RN
• Rachel Lina Gima, CNM
• Gladys' Counseling Place, PLLC-Where Life'S Moments Make You Stronger
• Colleen Golnik, LMFT
• Robert Clare Goodwin, M.D.
• Wendy K Goudreault, LCSW
• Sarah Graceffa, M.D.
• Andrea M Grant, LCSW
• Julian Grant, RN

• Gerontology Nurse Practitioner in South Windsor, CT
• Providers in South Windsor, CT by specialty
• Gerontology Nurse Practitioner in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.