Evangeline Mercado Gonzal, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

041840 Issued in NY

Practice address

17119 Hillside Ave
Jamaica, NY 11432-4548

Phone

(718) 400-7000

Fax

(718) 400-7001

NPI assigned

Dec 3, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2020

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Group practices

Montefiore Medical CenterGroup PAC ID 3779496021, 2,809 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Networks

• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H3359
• Healthfirst Medicare Network H1722

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.

• Montefiore Medical Center

  • Anesthesiology Physician
  • Bronx, NY
  • NPI 1063525152
  Medicare reassignment Care Compare group NPD
• Montefiore Medical Center

  • Community/Retail Pharmacy
  • Bronx, NY
  • NPI 1194183715
  NPD

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

{
    "created_epoch": "1606953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614556800000",
    "number": "1548865744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17119 HILLSIDE AVE",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114324548",
            "telephone_number": "718-400-7000",
            "fax_number": "718-400-7001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17119 HILLSIDE AVE",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114324548",
            "telephone_number": "718-400-7000",
            "fax_number": "718-400-7001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZAL",
        "first_name": "EVANGELINE",
        "middle_name": "MERCADO",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-03",
        "last_updated": "2021-03-01",
        "certification_date": "2021-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "041840",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sara Goldman, MSCCCSPEECH
• Vadim Goldshteyn, M.D.
• Natalia Gomez
• Nestor E Gomez
• Renee Marlene Gomez, LMSW
• Ma. Lourdes C. Gonzales, M.D.
• Trisha Gonzales, PT
• Diane L Gonzalez, MSW
• Edith Jannette Gonzalez
• Emily Gonzalez

• Physical Therapist in Jamaica, NY
• Providers in Jamaica, NY by specialty
• Physical Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.

Verify at the official NPI Registry.