Individual provider Active NPI

Marco Antonio Gonzalez

  • Nurse Practitioner
  • Visalia, CA
National Provider Identifier
1487302170
Registry record updated Oct 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
95024226 Issued in CA
Practice address
221 E Caldwell Ave
Visalia, CA 93277-7605
Phone
(559) 732-4726
Fax
(559) 732-4726
NPI assigned
Mar 13, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 24, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X 5015923 NC
Nurse Practitioner 363L00000X 95024226 CA Primary

Addresses

Primary practice location

221 E Caldwell Ave
Visalia, CA 93277-7605

Mailing address

221 E Caldwell Ave
Visalia, CA 93277-7605
Phone (559) 732-4726

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230417002318 CA Practitioner - Nurse Practitioner 7113306275 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
William C Holvik MD a Professional CorporationGroup PAC ID 4082909759, 3 clinicians

Practice addresses (Care Compare)

221 E Caldwell Ave
Visalia, CA 93277-7605
Phone (559) 732-4726

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America - California Multi-Specialty Current Accepting new patients
Cep America-California Multi-Specialty CurrentSince Apr 17, 2023 Accepting new patients
Cep America - California Multi-Specialty Current Accepting new patients
Cep America - California Multi-Specialty CurrentSince Apr 17, 2023 Accepting new patients
William C Holvik MD a Professional Corporation Multi-Specialty CurrentSince Jul 5, 2023 Accepting new patients
Cep America - California Multi-Specialty CurrentSince Apr 17, 2023 Accepting new patients
Kaweah Delta Health Care District Multi-Specialty PastSince Jul 5, 2023 Accepting new patients

Locations

2755 Herndon Ave
Clovis, CA 93611
Phone (559) 323-4000

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

15031 Rinaldi St
San Fernando, CA 91345
Phone (818) 365-8051

869 N Cherry St
Tulare, CA 93274
Phone (559) 326-2800

221 E Caldwell Ave
Visalia, CA 93277
Phone (559) 732-4726

Organizations & group practices 7

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

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1647129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698105600000",
    "number": "1487302170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "221 E CALDWELL AVE",
            "city": "VISALIA",
            "state": "CA",
            "postal_code": "932777605",
            "telephone_number": "559-732-4726",
            "fax_number": "559-732-4747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 E CALDWELL AVE",
            "city": "VISALIA",
            "state": "CA",
            "postal_code": "932777605",
            "telephone_number": "559-732-4726",
            "fax_number": "559-732-4726"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "MARCO",
        "middle_name": "ANTONIO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-03-13",
        "last_updated": "2023-10-24",
        "certification_date": "2023-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5015923",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95024226",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Visalia, CA

Sources for this page

Verify at the official NPI Registry.