Individual provider Active NPI

Elena Marie Gonzalez, P.N.P.

  • Pediatric Nurse Practitioner
  • New York, NY
National Provider Identifier
1568586444
Registry record updated Feb 12, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
F381615 Issued in NY
Practice address
180 Fort Washington Ave
New York, NY 10032-3722
Phone
(646) 426-3876
Fax
(212) 342-6865
NPI assigned
Mar 18, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X F381615 NY Primary

Addresses

Primary practice location

180 Fort Washington Ave
New York, NY 10032-3722

Mailing address

710 W 168TH St
New York, NY 10032-3726
Phone (212) 342-6867

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F381615NYMDPediatric Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1174176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1518393600000",
    "number": "1568586444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 W 168TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100323726",
            "telephone_number": "212-342-6867",
            "fax_number": "212-342-6865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 FORT WASHINGTON AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100323722",
            "telephone_number": "646-426-3876",
            "fax_number": "212-342-6865"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "ELENA",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "P.N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-18",
        "last_updated": "2018-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NY",
            "license": "F381615",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.