Individual provider Active NPI

Deborah M. Gonzalez, BA

  • Clinical Neuropsychologist
  • Dallas, TX
National Provider Identifier
1609047299
Registry record updated Mar 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
39220 Issued in TX
Practice address
1440 Empire Central Dr
Dallas, TX 75247-4091
Phone
(214) 648-4646
Fax
(214) 648-4660
NPI assigned
Mar 21, 2008
Last updated
Mar 14, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X 024006-01 NY
Clinical Neuropsychologist 103G00000X 39220 TX Primary

Addresses

Primary practice location

1440 Empire Central Dr
Dallas, TX 75247-4091

Mailing address

PO Box 845347
Dallas, TX 75284-5347
Phone (214) 645-0624

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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 1

Enrollment IDStateProvider typePAC IDDetails
I20220127002723 TX Practitioner - Clinical Psychologist 4981011707 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

6333 Forest Park Dr
Dallas, TX 75390-9087
Phone (214) 645-8500

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82.87 of 100Reported as group
Quality
70.15
Promoting interoperability
100
Improvement activities
40
Cost
72.75

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Bachelor of Arts

State licenses

LicenseStateTypeSpecialty
024006-01NYMDClinical Neuropsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
The University of Texas Southwestern Medical Center at Dallas CurrentSince Feb 1, 2022 Accepting new patients
University of Texas Southwestern Medical Center at Dallas CurrentSince Feb 1, 2022 Accepting new patients
University of Texas Southwestern Medical Center at Dallas Current Accepting new patients
University of Texas Southwestern Medical Center at Dallas PastSince Feb 1, 2022 Accepting new patients

Locations

5151 Harry Hines Blvd
Dallas, TX 75235
Phone (214) 590-3000

5201 Harry Hines Blvd
Dallas, TX 75235
Phone (214) 590-1396

6333 Forest Park Rd
Dallas, TX 75235
Phone (214) 902-0800

6333 Forest Park Rd
Fl 1
Dallas, TX 75235
Phone (214) 648-4646

5323 Harry Hines Blvd
Ut Southwest Medical Center, TX 75390

Organizations & group practices 4

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1206057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678752000000",
    "number": "1609047299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 845347",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752845347",
            "telephone_number": "214-645-0624",
            "fax_number": "214-645-0078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1440 EMPIRE CENTRAL DR",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752474091",
            "telephone_number": "214-648-4646",
            "fax_number": "214-648-4660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "DEBORAH",
        "middle_name": "M.",
        "credential": "BA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-21",
        "last_updated": "2023-03-14",
        "certification_date": "2023-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "NY",
            "license": "024006-01",
            "primary": false
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "TX",
            "license": "39220",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.