Agnes E Gonzaga, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

NP95012951 Issued in CA

Practice address

4955 Van Nuys Blvd Ste 411
Sherman Oaks, CA 91403-1824

Phone

(818) 784-1195

NPI assigned

Jun 2, 2021

Last updated

Jun 2, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Medison CorpGroup PAC ID 6103229000, 12 clinicians

Exer Medical CorporationGroup PAC ID 9032359534, 336 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Exer Medical Corporation

  dba Exer Urgent Care

  • Urgent Care Clinic/Center
  • Calabasas, CA
  • NPI 1588901532
  Medicare reassignment Care Compare group NPD
• Medison Corp

  dba AFC Urgent Care and Family Care

  • Urgent Care Clinic/Center
  • Torrance, CA
  • NPI 1760050587
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1622592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622592000000",
    "number": "1659947380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4955 VAN NUYS BLVD STE 411",
            "city": "SHERMAN OAKS",
            "state": "CA",
            "postal_code": "914031824",
            "telephone_number": "818-784-1195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4955 VAN NUYS BLVD STE 411",
            "city": "SHERMAN OAKS",
            "state": "CA",
            "postal_code": "914031824",
            "telephone_number": "818-784-1195"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZAGA",
        "first_name": "AGNES",
        "middle_name": "E",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-02",
        "last_updated": "2021-06-02",
        "certification_date": "2021-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "NP95012951",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Edward Lee Goldstein, PT
• Elizabeth C Gomez
• Giuliana Luzexcelalis Gomez
• Jaylene Gomez
• Julia Manuela Gomez, BT
• Gerienne Pangan Gonzaga
• Michael B Gonzales
• Ramil Gonzales
• Richard Alan Gonzales, MS, OTR/L
• Nancy L Gonzalez Andrade

• Family Nurse Practitioner in Sherman Oaks, CA
• Providers in Sherman Oaks, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2021; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.