Active NPI
Samely M Gonzalez
- Family Nurse Practitioner
- Richmond, CA
National Provider Identifier
1598655110
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 95033736
- Practice address
- 1714 Potrero Ave
Richmond, CA 94804-3831 - Phone
- (484) 538-9460
- NPI assigned
- Jul 7, 2025
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 95033736 | CA | Primary |
Addresses
Primary practice location
1714 Potrero Ave
Richmond, CA 94804-3831
Mailing address
1714 Potrero Ave
Richmond, CA 94804-3831
Phone (484) 538-9460
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: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20251024000629 | CA | Order and Referring Only - Nurse Practitioner | 5193213734 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 95033736 | CA | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1751846400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1751846400000",
"number": "1598655110",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1714 POTRERO AVE",
"city": "RICHMOND",
"state": "CA",
"postal_code": "948043831",
"telephone_number": "484-538-9460"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1714 POTRERO AVE",
"city": "RICHMOND",
"state": "CA",
"postal_code": "948043831",
"telephone_number": "484-538-9460"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GONZALEZ",
"first_name": "SAMELY",
"middle_name": "M",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-07-07",
"last_updated": "2025-07-07",
"certification_date": "2025-07-06",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "CA",
"license": "95033736",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Richmond, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2025; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.