Individual provider Active NPI

Alexandra Maria Gonzalez Minero, MD

  • Pediatrics Physician
  • Bronx, NY
National Provider Identifier
1649765447
Registry record updated Aug 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
312301 Issued in NY
Practice address
4422 3Rd Ave
Bronx, NY 10457-2594
Phone
(929) 310-7360
NPI assigned
Jun 25, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Pediatrics Physician 208000000X 312301 NY Primary

Addresses

Primary practice location

4422 3Rd Ave
Bronx, NY 10457-2594

Mailing address

4422 3Rd Ave
Bronx, NY 10457-2594
Phone (929) 310-7360

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20210917001802 NY Practitioner - Pediatric Medicine 9032516059 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
312301NYMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
SBH Physicians, PC Pediatrics Current Accepting new patients
SBH Physicians, PC Pediatrics CurrentSince Jun 21, 2023 Accepting new patients
St. Barnabas Hospital Past Accepting new patients
Quarry Road Emergency Services P.C. Past Accepting new patients
Arthur Avenue Pediatrics PC Pediatrics Past Accepting new patients

Locations

4487 3rd Ave
Bronx, NY 10457
Phone (718) 960-3730

2016 Bronxdale Ave
Ste 203
Bronx, NY 10462
Phone (718) 597-0700

4422 3rd Ave
Bronx, NY 10457
Phone (718) 960-3917

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989

Interoperability endpoints

  • Direct secure messaging: alexandra.gonzalez.1@18107.direct.athenahealth.com
  • Direct secure messaging: agonzalez18647@sbhny.direct-ci.net

Organizations & group practices 5

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": "1529884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629072000000",
    "number": "1649765447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4422 3RD AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104572594",
            "telephone_number": "929-310-7360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4422 3RD AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104572594",
            "telephone_number": "929-310-7360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ MINERO",
        "first_name": "ALEXANDRA",
        "middle_name": "MARIA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-25",
        "last_updated": "2021-08-16",
        "certification_date": "2021-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "312301",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.