Individual provider Active NPI

Andrea Paola Gonzalez Izquierdo, OD

  • Optometrist
  • Newport News, VA
National Provider Identifier
1700777208
Registry record updated Jul 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
0618003530 Issued in VA
Practice address
12551 Jefferson Ave
Newport News, VA 23602-4399
Phone
(757) 988-8020
NPI assigned
Jul 12, 2025
Last updated
Jul 12, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 0618003530 VA Primary

Addresses

Primary practice location

12551 Jefferson Ave
Newport News, VA 23602-4399

Mailing address

328 26TH St Apt E
Fort Eustis, VA 23604-1135

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
0618003530VAMDOptometrist

NPI Registry JSON

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

{
    "created_epoch": "1752278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752278400000",
    "number": "1700777208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "328 26TH ST APT E",
            "city": "FORT EUSTIS",
            "state": "VA",
            "postal_code": "236041135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12551 JEFFERSON AVE",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236024399",
            "telephone_number": "757-988-8020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ IZQUIERDO",
        "first_name": "ANDREA",
        "middle_name": "PAOLA",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-07-12",
        "last_updated": "2025-07-12",
        "certification_date": "2025-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "VA",
            "license": "0618003530",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport News, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.