David Andres Gonzalez, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

07101680 Issued in IL

Practice address

1725 W Harrison St Ste 755
Chicago, IL 60612-3863

Phone

(312) 563-2024

NPI assigned

Jan 25, 2016

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 2

Medicare fee-for-service enrollment

Enrolled in TX, IL2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Clinical Psychologist

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Rush University Medical GroupGroup PAC ID 5496658874, 1,521 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Rush University Medical Center Hospital, Chicago, IL, CCN 140119

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: dgonzalez25089@direct.utmsa.com

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.

• Rush University Medical Group

  • Internal Medicine Physician
  • Chicago, IL
  • NPI 1093819542

  Clinical

  Medicare reassignment Care Compare group NPD
• University of Texas Health Science Center at San Antonio

  • Internal Medicine Physician
  • San Antonio, TX
  • NPI 1720051717
  Medicare reassignment NPD
• Rush University Medical Center

  • Internal Medicine Physician
  • Chicago, IL
  • NPI 1689165540
  NPD
• The University of Texas Health Science Center at San Antonio

  • General Acute Care Hospital
  • San Antonio, TX
  • NPI 1326829904
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Rush University Medical Center

  • Children's Hospital
  • Chicago, IL
  • NPI 1801908728
  Care Compare affiliation
• Rush University Medical Center

  • General Acute Care Hospital
  • Chicago, IL
  • NPI 1932213600
  Care Compare affiliation

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

{
    "created_epoch": "1453680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639440000000",
    "number": "1588021307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1725 W HARRISON ST STE 755",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123863",
            "telephone_number": "312-563-2024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1725 W HARRISON ST STE 755",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123863",
            "telephone_number": "312-563-2024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "DAVID",
        "middle_name": "ANDRES",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-01-25",
        "last_updated": "2021-12-14",
        "certification_date": "2021-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "TX",
            "license": "37041",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "07101680",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TX",
            "license": "37041",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "360215301",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CSHCN",
            "identifier": "360215302",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Claudia Isis Gonzalez
• Cristina Gonzalez
• Crystal Gonzalez
• Cynthia Gonzalez
• Daniel Gonzalez, MSN, FNP-BC, NP-C
• Denise Gonzalez
• Emma Franco Gonzalez
• Emmanuel Gonzalez, PSYD
• Enrique Gonzalez, PH.D.
• Evert Gonzalez

• Clinical Psychologist in Chicago, IL
• Providers in Chicago, IL by specialty
• Clinical Psychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2021; 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.