Active NPI
Michael Alexis Gonzalez
- Physician Assistant
- Colton, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA67109
- Practice address
- 400 N Pepper Ave # 205
Colton, CA 92324-1801 - Phone
- (909) 580-1775
- NPI assigned
- May 19, 2025
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA67109 | CA | Primary |
Addresses
Primary practice location
400 N Pepper Ave # 205
Colton, CA 92324-1801
Mailing address
400 N Pepper Ave # 205
Colton, CA 92324-1801
Phone (909) 580-1775
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2025
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
400 N Pepper Ave
Arrowhead
Colton, CA 92324-1801
Phone (909) 580-3390
Hospital & facility affiliations
- Riverside Community Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 67109 | CA | MD | Pharmacist |
| PA67109 | CA | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| San Bernardino Medical Orthopaedic Group, Inc. | Current | Accepting new patients | |
| San Bernardino Medical Orthopaedic Group, Inc. | Current | Accepting new patients |
Locations
400 N Pepper Ave
#205
Colton, CA 92324
Phone (909) 331-9598
400 N Pepper Ave
Colton, CA 92324
Phone (909) 580-1800
1798 N Garey Ave
Pomona, CA 91767
Phone (909) 865-9810
1901 W Lugonia Ave
Ste 310
Redlands, CA 92374
Phone (909) 793-2964
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 and National Provider Directory roles.
-
- Orthopaedic Surgery Physician
- Redlands, CA
- NPI 1336187475
-
- Orthopaedic Surgery Physician
- Beaumont, CA
- NPI 1235964537
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Riverside, CA
- NPI 1114971660
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1747612800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1760400000000",
"number": "1497547137",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "400 N PEPPER AVE # 205",
"city": "COLTON",
"state": "CA",
"postal_code": "923241801",
"telephone_number": "909-580-1775"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "400 N PEPPER AVE # 205",
"city": "COLTON",
"state": "CA",
"postal_code": "923241801",
"telephone_number": "909-580-1775"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GONZALEZ",
"first_name": "MICHAEL",
"middle_name": "ALEXIS",
"name_prefix": "Mr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2025-05-19",
"last_updated": "2025-10-14",
"certification_date": "2025-10-14",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CA",
"license": "PA67109",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Colton, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2025; 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.