Alberto J Gonzalez, MD
Individual provider Active NPI Psychiatry Physician · Orangeburg, SC
NPI 1487677696 · NPPES record last updated Apr 30, 2013
Key facts
- NPI
- 1487677696
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatry Physician 2084P0800X
- License
- 15347 (SC)
- Practice address
- 2323 St Matthews Rd
Orangeburg, SC 29118 - Phone
- (803) 534-0042
- Fax
- (803) 531-0676
- NPI assigned
- Jul 26, 2006
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Psychiatry
- Education
- Other, 1987
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
2323 Saint Matthews Rd
Orangeburg, SC 29118-2042
Phone (803) 534-0042
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in SC
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040713000927 | SC | Practitioner - Psychiatry | 6305824582 |
Receives reassigned benefits from 1 practitioner Practice locations: Orangeburg, SC |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Alberto J. Gonzalez MD | Psychiatry | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 15347 | SC | Yes |
Addresses
Primary practice location
2323 St Matthews Rd
Orangeburg, SC 29118
Mailing address
2323 St Matthews Rd
Orangeburg, SC 29118
Phone (803) 534-0042
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 153470 | Medicaid | SC |
Other providers in Orangeburg, SC
- Nicole Glover
- Sonja D Glover
- Glover'S Home Improvement LLC
- Della Glynn
- Diana Godfrey
- Sabrina T Gonzalez
- Hilliary Goode
- Cheri Franklin Goodman
- Stephen Goodwin
- Erin W Gooldy
All providers in Orangeburg, SC · Psychiatry Physician in South Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 30, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.