Individual provider Active NPI

Jose Rodrigo Gonzalez-Correa, MD

  • Family Medicine Physician
  • Panorama City, CA
National Provider Identifier
1598360794
Registry record updated Jun 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A188139 Issued in CA
Practice address
14860 Roscoe Blvd Ste 200
Panorama City, CA 91402-4683
Phone
(818) 904-3132
NPI assigned
Dec 3, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A188139 CA Primary

Addresses

Primary practice location

14860 Roscoe Blvd Ste 200
Panorama City, CA 91402-4683

Mailing address

14427 Chase St Ste 100
Panorama City, CA 91402-3020

Other practice location 1

14427 Chase St Ste 100
Panorama City, CA 91402-3020
Phone (818) 830-7751

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230912000607 CA Practitioner - Family Practice 5496119323 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A188139CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Innovative Medical Solutions Inc a Medical Group CurrentSince Mar 20, 2024 Accepting new patients
Santo Nino Medical Group Inc Family Medicine Past Accepting new patients

Locations

8920 Wilshire Blvd
Ste 310
Beverly Hills, CA 90211
Phone (310) 256-2426

14860 Roscoe Blvd
Ste 200
Panorama City, CA 91402
Phone (818) 830-7751

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1606953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750982400000",
    "number": "1598360794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14427 CHASE ST STE 100",
            "city": "PANORAMA CITY",
            "state": "CA",
            "postal_code": "914023020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14860 ROSCOE BLVD STE 200",
            "city": "PANORAMA CITY",
            "state": "CA",
            "postal_code": "914024683",
            "telephone_number": "818-904-3132"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14427 Chase St Ste 100",
            "address_purpose": "LOCATION",
            "city": "Panorama City",
            "state": "CA",
            "postal_code": "914023020",
            "country_code": "US",
            "telephone_number": "818-830-7751",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GONZALEZ-CORREA",
        "first_name": "JOSE",
        "middle_name": "RODRIGO",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-12-03",
        "last_updated": "2025-06-27",
        "certification_date": "2024-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A188139",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "13652 Cantara St",
            "city": "Panorama City",
            "state": "CA",
            "country_code": "US",
            "postal_code": "914025423",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Panorama City, CA

Sources for this page

Verify at the official NPI Registry.