Luis Alberto Gonzalez, MD

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

01080663A Issued in IN

Practice address

3505 Lake City Hwy
Warsaw, IN 46580-3942

Phone

(574) 269-4144

Fax

(574) 268-2281

NPI assigned

Oct 6, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

Other names 1

• Luis Alberto Vazquez Other name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MI, WI2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: luis.gonzalez@lutheranhealthnetwork.cernerdirect.com

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.

• Aspirus Rhinelander & Tomahawk Hospitals & Clinics, Inc.

  • Clinic/Center
  • Stevens Point, WI
  • NPI 1144991340
  Medicare reassignment NPD
• Edward W. Sparrow Hospital Association

  • Pediatrics Physician
  • Lansing, MI
  • NPI 1831139088
  Medicare reassignment NPD
• Aspirus Rhinelander & Tomahawk Hospitals & Clinics, Inc.

  • General Acute Care Hospital
  • Rhinelander, WI
  • NPI 1356391247
  NPD
• Edward W Sparrow Hospital Association

  • Adult Health Nurse Practitioner
  • Lansing, MI
  • NPI 1265220438
  NPD
• Edward W. Sparrow Hospital Association

  • Obstetrics & Gynecology Physician
  • Lansing, MI
  • NPI 1083669881
  NPD
• Edward W. Sparrow Hospital Association

  • Urgent Care Clinic/Center
  • East Lansing, MI
  • NPI 1477509313
  NPD (past)

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

{
    "created_epoch": "1160092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601510400000",
    "number": "1679660260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 13008",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489013008",
            "telephone_number": "517-364-6253",
            "fax_number": "517-364-6208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3505 LAKE CITY HWY",
            "city": "WARSAW",
            "state": "IN",
            "postal_code": "465803942",
            "telephone_number": "574-269-4144",
            "fax_number": "574-268-2281"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1100 W Saginaw St",
            "address_2": "Suite 630",
            "address_purpose": "LOCATION",
            "city": "Lansing",
            "state": "MI",
            "postal_code": "489151925",
            "country_code": "US",
            "telephone_number": "517-364-6363",
            "fax_number": "517-364-6364",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "LUIS",
        "middle_name": "ALBERTO",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-06",
        "last_updated": "2020-10-01",
        "certification_date": "2020-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MI",
            "license": "4301054514",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "IN",
            "license": "01080663A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4288420",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS INDIVIDUAL PIN",
            "identifier": "1603304641",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2868162",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "luis.gonzalez@lutheranhealthnetwork.cernerdirect.com",
            "affiliation": "N",
            "endpointDescription": "AMR direct address",
            "address_1": "3505 Lake City Hwy",
            "city": "Warsaw",
            "state": "IN",
            "country_code": "US",
            "postal_code": "465803942",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "LUIS",
            "last_name": "VAZQUEZ",
            "middle_name": "ALBERTO",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Amy Lynn Gilbert, LMHC
• Hunter Matthew Gilliam, PHARMD
• Kaia Golden
• Janis Gongwer
• Abigail Gonzalez
• Chad Goon
• Stephanie Nicole Goss, PHARMD
• Jena Elizabeth Gould, NP
• Mykenzee Gouwens
• Corey French Graham, M.D.

• Obstetrics & Gynecology Physician in Warsaw, IN
• Providers in Warsaw, IN by specialty
• Obstetrics & Gynecology Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2020; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.