Individual provider Active NPI

Miriam Gonzalez, NP

  • Nurse Practitioner
  • Cedar Park, TX
National Provider Identifier
1639975915
Registry record updated Mar 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
1023448 Issued in TX
Practice address
200 N Lakeline Blvd Ste a
Cedar Park, TX 78613-2089
Phone
(512) 617-3000
NPI assigned
Feb 19, 2025
Last updated
Mar 26, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 1023448 TX Primary

Addresses

Primary practice location

200 N Lakeline Blvd Ste a
Cedar Park, TX 78613-2089

Mailing address

8800 Willowick Dr
Austin, TX 78759-7537

Other practice location 1

8825 Bee Caves Rd
Austin, TX 78746-4720
Phone (512) 328-3376

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: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260130000579 TX Practitioner - Nurse Practitioner 4981182086 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

13492 Research Blvd
Suite 120
Austin, TX 78750

8825 Bee Caves Rd
Suite 100
Austin, TX 78746

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1023448TXMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Westlake Dermatology, PA CurrentSince Feb 1, 2026 Accepting new patients
Westlake Dermatology PA PastSince Mar 30, 2025 Accepting new patients

Locations

12201 Renfert Way
Ste 305
Austin, TX 78758
Phone (513) 279-3376

200 N Lakeline Blvd
Ste A
Cedar Park, TX 78613
Phone (512) 617-3000

401 S FM 620 Rd
Ste 200
Lakeway, TX 78734
Phone (512) 610-0549

1760 Round Rock Ave
Round Rock, TX 78681
Phone (512) 583-3376

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1739923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742947200000",
    "number": "1639975915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8800 WILLOWICK DR",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787597537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 N LAKELINE BLVD STE A",
            "city": "CEDAR PARK",
            "state": "TX",
            "postal_code": "786132089",
            "telephone_number": "512-617-3000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8825 Bee Caves Rd",
            "address_purpose": "LOCATION",
            "city": "Austin",
            "state": "TX",
            "postal_code": "787464720",
            "country_code": "US",
            "telephone_number": "512-328-3376",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "MIRIAM",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-02-19",
        "last_updated": "2025-03-26",
        "certification_date": "2025-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "1023448",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cedar Park, TX

Sources for this page

Verify at the official NPI Registry.