Victoria Beatriz Gonzalez, AU.D.
Individual provider Active NPI Audiologist · Jackson, MS
NPI 1679723902 · NPPES record last updated Jan 31, 2014
Key facts
- NPI
- 1679723902
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Audiologist 231H00000X
- License
- A3705 (MS)
- Practice address
- 2500 N State St
Department of Otolaryngology
Jackson, MS 39216-4500 - Phone
- (601) 815-4775
- Fax
- (601) 984-6451
- NPI assigned
- Sep 23, 2008
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 24
Medicare Care Compare profile
- Specialty
- Qualified Audiologist
- Education
- Other, 2009
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- State of Mississippi - University of Mississippi Medical Center
Practice addresses (Care Compare)
2500 N State St
Jackson, MS 39216-4500
Phone (601) 815-4775
Merit-based Incentive Payment System (MIPS)
- Final score
- 83.94 of 100
- Quality
- 67.75
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 71.17
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MS
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20130521000685 | MS | Practitioner - Qualified Audiologist | 4688854441 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AY1572 | FL | MD | Audiologist |
| A3705 | MS | MD | Audiologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| State of Mississippi - University of Mississippi Medical Center | Current |
Accepting new patients | |
| State of Mississippi - University of Mississippi Medical Center | Current |
Accepting new patients | |
| University Physicians, PLLC | Past | Accepting new patients |
Locations
764 Lakeland Dr
Jackson, MS 39216
Phone (601) 982-0611
2500 N State St
Jackson, MS 39216
Phone (601) 815-4775
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Audiologist | 231H00000X | AY1572 | FL | |
| Audiologist | 231H00000X | A3705 | MS | Yes |
| Audiologist-Hearing Aid Fitter | 237600000X | AY1572 | FL |
Addresses
Primary practice location
2500 N State St
Department of Otolaryngology
Jackson, MS 39216-4500
Mailing address
2500 N State St
Jackson, MS 39216-4500
Phone (601) 815-4775
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 002917500 | Medicaid | FL | |
| 002917501 | Medicaid | FL | |
| 00336063 | Medicaid | MS |
Other providers in Jackson, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 31, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.