Individual provider Active NPI

Jessica Gonzalez, APRN

  • Family Nurse Practitioner
  • Wellington, FL
National Provider Identifier
1508547373
Registry record updated Jul 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11027242 Issued in FL
Practice address
1397 Medical Park Blvd Ste 300
Wellington, FL 33414-3187
Phone
(561) 964-8221
Fax
(561) 964-7393
NPI assigned
Jul 26, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 11027242 FL Primary

Addresses

Primary practice location

1397 Medical Park Blvd Ste 300
Wellington, FL 33414-3187

Mailing address

15157 Banbury Way
Wellington, FL 33414-8370
Phone (954) 232-5955

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230914004084 FL Practitioner - Nurse Practitioner 0042674624 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

5401 S Congress Ave
Suite 211
Atlantis, FL 33462-6637
Phone (214) 424-2200

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11027242FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Gastroenterology Associates of Florida LLC CurrentSince Jul 31, 2023 Accepting new patients

Locations

5401 S Congress Ave
Ste 211
Lake Worth, FL 33462

1397 Medical Park Blvd
Ste 300
Wellington, FL 33414
Phone (561) 798-4900

Organizations & group practices 1

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 2

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": "1690329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690329600000",
    "number": "1508547373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15157 BANBURY WAY",
            "city": "WELLINGTON",
            "state": "FL",
            "postal_code": "334148370",
            "telephone_number": "954-232-5955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1397 MEDICAL PARK BLVD STE 300",
            "city": "WELLINGTON",
            "state": "FL",
            "postal_code": "334143187",
            "telephone_number": "561-964-8221",
            "fax_number": "561-964-7393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "JESSICA",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-26",
        "last_updated": "2023-07-26",
        "certification_date": "2023-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11027242",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wellington, FL

Sources for this page

Verify at the official NPI Registry.