Individual provider Active NPI

Tara Gonzales, FNP-C

  • Family Nurse Practitioner
  • Wasilla, AK
National Provider Identifier
1700262763
Registry record updated Jul 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
206920 Issued in AK
Practice address
1861 E Parks Hwy
Wasilla, AK 99654-7350
Phone
(888) 227-3312
NPI assigned
Jul 31, 2015
Last updated
Jul 19, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP8007 AZ
Family Nurse Practitioner 363LF0000X 206920 AK Primary

Addresses

Primary practice location

1861 E Parks Hwy
Wasilla, AK 99654-7350

Mailing address

1861 E Parks Hwy
Wasilla, AK 99654-7350
Phone (888) 227-3312

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230901001244 AK Practitioner - Nurse Practitioner 6507175734 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Select Physical Therapy Holdings IncGroup PAC ID 9537076401, shared by 76 NPIs, 1,992 clinicians
Medical Network of Alaska LLCGroup PAC ID 3072618859, 70 clinicians

Practice addresses (Care Compare)

10928 Eagle River Rd
Eagle River, AK 99577-8078
Phone (907) 694-8085

1700 E Bogard Rd
Wasilla, AK 99654-6570
Phone (907) 921-5088

3122 E Meridian Park Loop
Wasilla, AK 99654-7255
Phone (907) 357-9590

3765 E Blue Lupine Dr
Suite C
Wasilla, AK 99654-8417
Phone (907) 357-9560

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.78 of 100Reported as group
Quality
92.1
Improvement activities
40
Cost
80.43

Merit-based Incentive Payment System (MIPS)

Final score
86.88 of 100Reported as group
Quality
80.34
Promoting interoperability
98
Improvement activities
40
Cost
77.59

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Network of Alaska, LLC CurrentSince Jun 2, 2025 Accepting new patients
Medical Network of Alaska, LLC Current Accepting new patients
Medical Network of Alaska, LLC Current Accepting new patients
Glacier Point Chiropractic CurrentSince Jan 19, 2025 Accepting new patients
Medical Network of Alaska, LLC CurrentSince Jun 2, 2025 Accepting new patients
Marana Health Center, Inc Past Accepting new patients
Express Care Ak LLC PastSince Apr 19, 2020 Accepting new patients
Medical Network of Alaska, LLC Past Accepting new patients

Locations

1861 E Parks Hwy
Wasilla, AK 99654
Phone (907) 308-2333

3122 E Meridian Park Loop
Wasilla, AK 99654
Phone (907) 864-4625

3331 E Meridian Park Loop
Wasilla, AK 99654
Phone (907) 357-2332

Interoperability endpoints

  • Direct secure messaging: tara.gonzales.1@27294.direct.athenahealth.com

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1438300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689724800000",
    "number": "1700262763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1861 E PARKS HWY",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996547350",
            "telephone_number": "888-227-3312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1861 E PARKS HWY",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996547350",
            "telephone_number": "888-227-3312"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALES",
        "first_name": "TARA",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-31",
        "last_updated": "2023-07-19",
        "certification_date": "2023-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "AP8007",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AK",
            "license": "206920",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wasilla, AK

Sources for this page

Verify at the official NPI Registry.