Benjamin S Gonzalez, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

D-0065055 Issued in MD

Practice address

12200 Tech Rd
Suite 102
Silver Spring, MD 20904-1983

Phone

(301) 622-2722

NPI assigned

May 22, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Mar 13, 2024 through Mar 13, 2028

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Frederick Health Hospital Inc

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)
• Emergency Medicine Physicians of Kanawha County, PLLC

  • Emergency Medicine Physician
  • South Charleston, WV
  • NPI 1326087289
  NPD (past)

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

{
    "created_epoch": "1148256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1285545600000",
    "number": "1679527766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12200 TECH RD",
            "address_2": "SUITE 102",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209041983",
            "telephone_number": "301-622-2722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12200 TECH RD",
            "address_2": "SUITE 102",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209041983",
            "telephone_number": "301-622-2722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "BENJAMIN",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-22",
        "last_updated": "2010-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "PA",
            "license": "MD068839L",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MD",
            "license": "D-0065055",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0018246820001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christine Qian Gong
• Nelson Bonglack Gonga, HHA
• Sergio David Gonzales
• Gonzalez Medical Offices, LLP
• Edgardo Gonzalez Munoz
• Elijah Gonzalez, LMSW
• Johnny Ramiro Gonzalez
• Luis Antonio Gonzalez, M.D.
• Xenia E Gonzalez, LMSW
• Kara Anne Goobic

• Emergency Medicine Physician in Silver Spring, MD
• Providers in Silver Spring, MD by specialty
• Emergency Medicine Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.