Jeffrey Michael Gonzales, FNP C

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

200650104NP Issued in OR

Practice address

1253 NW Canal Blvd
Redmond, OR 97756-1334

Phone

(541) 548-8131

Fax

(541) 526-6608

NPI assigned

Jun 13, 2006

Last updated

Jun 7, 2013By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in TX

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

Specialty

Nurse Practitioner

Education

University of Iowa, RJ & L Carver College of Medicine, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

First Response Urgent CareGroup PAC ID 0446578520, 4 clinicians

First Response Urgent Care-LumbertonGroup PAC ID 2466861927, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• First Response Urgent Care

  • Urgent Care Clinic/Center
  • Port Arthur, TX
  • NPI 1093113912
  Medicare reassignment Care Compare group NPD
• First Response Urgent Care-Lumberton

  dba First Response Urgent Care

  • Urgent Care Clinic/Center
  • Lumberton, TX
  • NPI 1285226381
  Medicare reassignment Care Compare group NPD
• Port Arthur Emergency Physicians

  • Emergency Medicine Physician
  • Port Arthur, TX
  • NPI 1255491627

  Nurse Practitioner

  Medicare reassignment NPD
• Northwest Physician Associates, Apc

  • Emergency Medicine Physician
  • Federal Way, WA
  • NPI 1407127442
  NPD (past)
• Tacoma Emergency Medicine Associates PC

  • Emergency Medicine Physician
  • Tacoma, WA
  • NPI 1134321888
  NPD (past)

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

{
    "created_epoch": "1150156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1370563200000",
    "number": "1578506390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 S 336TH ST",
            "address_2": "SUITE 600",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980036328",
            "telephone_number": "253-838-6180",
            "fax_number": "253-838-6418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1253 NW CANAL BLVD",
            "city": "REDMOND",
            "state": "OR",
            "postal_code": "977561334",
            "telephone_number": "541-548-8131",
            "fax_number": "541-526-6608"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALES",
        "first_name": "JEFFREY",
        "middle_name": "MICHAEL",
        "credential": "FNP C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-13",
        "last_updated": "2013-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "LA",
            "license": "AP04764",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IA",
            "license": "A-103474",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OR",
            "license": "200650104NP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8187320",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LIWA",
            "identifier": "0213580",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BSWA",
            "identifier": "5971GO",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Greg Michael Ginsburg, D.M.D.
• Janell Schuetze Ginsburg, D.M.D.
• Claire Denise Giovanni
• Megan Elizabeth Gleason, MPT
• Kelly Gobler, COTA/L
• Laurie Gonzales, RPH
• Patricia Gonzalez
• Goodwin Counseling & Wellness LLC
• Kelly Ross Goodwin
• Melissa Goray

• Nurse Practitioner in Redmond, OR
• Providers in Redmond, OR by specialty
• Nurse Practitioner in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2013; 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.

Verify at the official NPI Registry.