Individual provider Active NPI

Christina Maria Gonzaga, D.O.

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Philadelphia, PA
National Provider Identifier
1609197052
Registry record updated Jun 21, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081P2900X
License
OS015004 Issued in PA
Practice address
834 Chestnut St
T150
Philadelphia, PA 19107-5127
Phone
(215) 955-2090
Fax
(215) 923-5086
NPI assigned
Jun 21, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 21, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Physical Medicine & Rehabilitation) Physician 2081P2900X OS015004 PA Primary

Addresses

Primary practice location

834 Chestnut St
T150
Philadelphia, PA 19107-5127

Mailing address

834 Chestnut St
T150
Philadelphia, PA 19107-5127
Phone (215) 955-2090

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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
I20111005000914 MN Practitioner - Physical Medicine and RehabilitationPractitioner - Pain Management 3375715816 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and RehabilitationAlso: Pain Management
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Park Nicollet ClinicGroup PAC ID 7911819438, 1,778 clinicians

Practice addresses (Care Compare)

14000 Fairview Dr
Burnsville, MN 55337-5713
Phone (952) 993-8700

3800 Park Nicollet Blvd
St Louis Park, MN 55416-2527
Phone (952) 993-3123

3850 Park Nicollet Blvd
St Louis Park, MN 55416-2527
Phone (952) 993-3123

5320 Hyland Greens Dr
Bloomington, MN 55437-3934
Phone (952) 993-2400

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS015004PAMDPain Medicine (Physical Medicine & Rehabilitation) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Park Nicollet Clinic CurrentSince Aug 15, 2011 Accepting new patients
Park Nicollet Clinic Current Accepting new patients
Tria Orthopaedic Center LLC CurrentSince Aug 1, 2025 Accepting new patients

Locations

9555 Upland Ln N
Maple Grove, MN 55369
Phone (952) 993-1440

5320 Hyland Greens Dr
Minneapolis, MN 55437
Phone (952) 993-2400

8100 Northland Dr
Minneapolis, MN 55431
Phone (952) 831-1626

3800 Park Nicollet Blvd
St Louis Park, MN 55416
Phone (952) 993-1000

Organizations & group practices 3

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.

Hospital & facility affiliations 6

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": "1277078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277078400000",
    "number": "1609197052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "834 CHESTNUT ST",
            "address_2": "T150",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191075127",
            "telephone_number": "215-955-2090",
            "fax_number": "215-923-5086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "834 CHESTNUT ST",
            "address_2": "T150",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191075127",
            "telephone_number": "215-955-2090",
            "fax_number": "215-923-5086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZAGA",
        "first_name": "CHRISTINA",
        "middle_name": "MARIA",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-06-21",
        "last_updated": "2010-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2081P2900X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "PA",
            "license": "OS015004",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.