Individual provider Active NPI

Tara L Gonzalez, PT

  • Physical Therapist
  • Colorado Springs, CO
National Provider Identifier
1710312459
Registry record updated Sep 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
0012294 Issued in CO
Practice address
8540 Scarborough Dr Ste 200
Colorado Springs, CO 80920-7513
Phone
(719) 630-7500
NPI assigned
Sep 12, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 12, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 0012294 CO Primary

Addresses

Primary practice location

8540 Scarborough Dr Ste 200
Colorado Springs, CO 80920-7513

Mailing address

13951 E 104TH Dr
Commerce City, CO 80022-9448
Phone (352) 422-6562

Other identifiers 1

IdentifierTypeStateIssuer
0012294OtherCOMEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211216001914 CO Practitioner - Physical Therapist in Private Practice 8022409523

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0012294COMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Western Orthopaedics, P.C. Current Accepting new patients
Peak Rehabilitation of Denver LLC Physical Therapist Past Accepting new patients
Wsi Past Accepting new patients
Peak Rehabilitation of Denver LLC Physical Therapist Past Accepting new patients
Peak Physical Therapy at Highlands Ranch Physical Therapist Past Accepting new patients
Peak Physical Therapy at Highlands Ranch Past Accepting new patients
Peak Rehabilitation of Denver LLC Physical Therapist Past Accepting new patients

Locations

6870 W 52nd Ave
Ste 102
Arvada, CO 80002
Phone (303) 534-0391

1830 N Franklin St
Ste 400
Denver, CO 80218
Phone (303) 253-7373

1830 N Franklin St
Ste 450
Denver, CO 80218
Phone (303) 321-1333

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1378944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1378944000000",
    "number": "1710312459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13951 E 104TH DR",
            "city": "COMMERCE CITY",
            "state": "CO",
            "postal_code": "800229448",
            "telephone_number": "352-422-6562"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8540 SCARBOROUGH DR STE 200",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809207513",
            "telephone_number": "719-630-7500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "TARA",
        "middle_name": "L",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-09-12",
        "last_updated": "2013-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "0012294",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "0012294",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.