Salvador Gonzalez Jr., OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

046011652 Issued in IL

Practice address

6201 W 95TH St
Oak Lawn, IL 60453-3888

Phone

(708) 636-9393

Fax

(708) 636-2022

NPI assigned

Jul 22, 2021

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

Medicare fee-for-service enrollment

Enrolled in IL, MN2 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

Specialty

Ophthalmology

Education

Illinois College of Optometry at Chicago, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Fairview Specialty ServicesGroup PAC ID 3072083286, 303 clinicians

Fairview Express CareGroup PAC ID 3375645179, 1,946 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• M Health Fairview University of MN Medical Center Hospital, Minneapolis, MN, CCN 240080

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: sgonzalez914032@fairview.direct-ci.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.

• Fairview Express Care

  • Multi-Specialty Clinic/Center
  • Minneapolis, MN
  • NPI 1053952606
  Medicare reassignment Care Compare group NPD
• Fairview Specialty Services

  • Clinic/Center
  • Minneapolis, MN
  • NPI 1588543862
  Medicare reassignment Care Compare group
• Family Eye Physicians, LTD

  • Ophthalmology Physician
  • Oak Lawn, IL
  • NPI 1730252230

  Optometrist

  Medicare reassignment NPD
• University of Minnesota Health Clinics and Surgery Center, Inc.

  • Clinic/Center
  • Minneapolis, MN
  • NPI 1053795187
  Medicare reassignment NPD
• University of Minnesota Physicians

  • Multi-Specialty Clinic/Center
  • Minneapolis, MN
  • NPI 1477598118
  Medicare reassignment NPD
• Fairview Express Care

  • General Practice Physician
  • Edina, MN
  • NPI 1831707207
  NPD
• Fairview Express Care

  • Clinic/Center
  • Burnsville, MN
  • NPI 1992075501
  NPD
• University of Minnesota Health Clinics and Surgery Center Inc

  • Anesthesiology Physician
  • Minneapolis, MN
  • NPI 1003485004
  NPD
• University of Minnesota Physicians

  • Primary Care Clinic/Center
  • Minneapolis, MN
  • NPI 1730586819
  NPD
• University of Minnesota Physicians

  • Dental Clinic/Center
  • Minneapolis, MN
  • NPI 1952546061
  NPD
• 20/20 Eye Physicians of Indiana P C

  • Ophthalmology Physician
  • Indianapolis, IN
  • NPI 1871588442
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Fairview Health Services

  • General Acute Care Hospital
  • Minneapolis, MN
  • NPI 1013994359
  Care Compare affiliation
• Fairview Health Services

  • General Acute Care Hospital
  • Minneapolis, MN
  • NPI 1316008212
  Care Compare affiliation
• Fairview Health Services

  • Skilled Nursing Facility
  • Minneapolis, MN
  • NPI 1669459913

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1626912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679529600000",
    "number": "1699348110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6201 W 95TH ST",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "604533888",
            "telephone_number": "708-636-9393",
            "fax_number": "708-636-2022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6201 W 95TH ST",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "604533888",
            "telephone_number": "708-636-9393",
            "fax_number": "708-636-2022"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3101 W 57th St",
            "address_purpose": "LOCATION",
            "city": "Sioux Falls",
            "state": "SD",
            "postal_code": "571083162",
            "country_code": "US",
            "telephone_number": "605-361-3937",
            "fax_number": "605-371-7199",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "17W682 Butterfield Rd Ste 101",
            "address_purpose": "LOCATION",
            "city": "Oakbrook Terrace",
            "state": "IL",
            "postal_code": "601814029",
            "country_code": "US",
            "telephone_number": "708-636-9393",
            "fax_number": "708-636-2022",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4459 N Kedzie Ave",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606254785",
            "country_code": "US",
            "telephone_number": "773-866-2020",
            "fax_number": "773-866-2022",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "14494 John Humphrey Dr",
            "address_purpose": "LOCATION",
            "city": "Orland Park",
            "state": "IL",
            "postal_code": "604622638",
            "country_code": "US",
            "telephone_number": "708-226-9393",
            "fax_number": "708-403-5751",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "68 W Dundee Rd",
            "address_purpose": "LOCATION",
            "city": "Buffalo Grove",
            "state": "IL",
            "postal_code": "600893758",
            "country_code": "US",
            "telephone_number": "847-541-3334",
            "fax_number": "847-541-8442",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "SALVADOR",
        "name_suffix": "Jr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-07-22",
        "last_updated": "2023-03-23",
        "certification_date": "2023-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "SD",
            "license": "774",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046011652",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amelia Gonzalez
• Andrea Isabel Gonzalez, MD
• Daniel Marcos Gonzalez, MD
• Maya Christy Gonzalez
• Paola Gonzalez
• Mekapeu Grace Gonzreu
• Nicholas William Goodmanson, MD
• Peyton Anne Goodrich
• Nihal Gooneratne, MD
• Carolyn Ann Goosby, DMIN, MDIV, LCSW

• Optometrist in Oak Lawn, IL
• Providers in Oak Lawn, IL by specialty
• Optometrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2023; 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.