Individual provider Active NPI

Alexander Michael Gonzalez

  • Occupational Therapist
  • Miami Lakes, FL
National Provider Identifier
1679089890
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OTT18884 Issued in FL
Practice address
15600 NW 67TH Ave
Miami Lakes, FL 33014-2174
Phone
(305) 828-8260
NPI assigned
Dec 26, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OTT18884 FL Primary

Addresses

Primary practice location

15600 NW 67TH Ave
Miami Lakes, FL 33014-2174

Mailing address

4081 W 6TH CT
Hialeah, FL 33012-3818

Other practice location 1

350 N Pine Island Rd
Plantation, FL 33324-1849
Phone (954) 476-8800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190416000686 FL Practitioner - Occupational Therapist in Private Practice 8921349135 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2017
Medicare assignment
May accept Medicare assignment
Group practices
MDR Rehab IncGroup PAC ID 2860481009, 4 clinicians

Practice addresses (Care Compare)

601 N Congress Ave
Suite 411
Delray Beach, FL 33445-4640
Phone (561) 638-1078

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OTT18884FLMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
MDR Rehab, Inc. CurrentSince Jan 1, 2021 Accepting new patients
Leverage Health, Inc. CurrentSince Feb 20, 2019 Accepting new patients

Locations

601 N Congress Ave
Ste 411
Delray Beach, FL 33445
Phone (561) 638-1078

2655 E Oakland Park Blvd
Ste 5
Oakland Park, FL 33306
Phone (954) 630-3131

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1514246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1679089890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4081 W 6TH CT",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330123818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15600 NW 67TH AVE",
            "city": "MIAMI LAKES",
            "state": "FL",
            "postal_code": "330142174",
            "telephone_number": "305-828-8260"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "350 N Pine Island Rd",
            "address_purpose": "LOCATION",
            "city": "Plantation",
            "state": "FL",
            "postal_code": "333241849",
            "country_code": "US",
            "telephone_number": "954-476-8800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "ALEXANDER",
        "middle_name": "MICHAEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-12-26",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "FL",
            "license": "OTT18884",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami Lakes, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.