Individual provider Active NPI

Jaime E Gonzalez, MD

  • Emergency Medicine Physician
  • Whittier, CA
National Provider Identifier
1730116385
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
A70475 Issued in CA
Practice address
12401 Washington Blvd
Whittier, CA 90602-1006
Phone
(562) 698-0811
Fax
(818) 587-2493
NPI assigned
Jun 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X A70475 CA Primary

Addresses

Primary practice location

12401 Washington Blvd
Whittier, CA 90602-1006

Mailing address

PO Box 4419
Woodland Hills, CA 91365-4419
Phone (800) 506-6895

Other identifiers 3

IdentifierTypeStateIssuer
00A704750OtherCABLUE SHIELD
P00018956OtherCARAILROAD MEDICARE
00A704750MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20040714001657 CA Practitioner - Emergency Medicine 1456330349 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Stanford University School of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cep America - CaliforniaGroup PAC ID 6103739131, shared by 2 NPIs, 1,278 clinicians

Practice addresses (Care Compare)

27300 Iris Ave
Moreno Valley, CA 92555-4802
Phone (651) 243-0811

Hospital & facility affiliations

  • Garden Grove Hospital & Medical Center Hospital, Garden Grove, CA, CCN 050230
  • Kaiser Foundation Hospital-Moreno Valley Hospital, Moreno Valley, CA, CCN 050765

Merit-based Incentive Payment System (MIPS)

Final score
96.69 of 100Reported as group
Quality
90
Improvement activities
40
Cost
78.43

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A70475CAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America-California Emergency Medicine CurrentSince Oct 10, 2002 Accepting new patients
Cep America - California Emergency Medicine Current Accepting new patients
Cep America - California Emergency Medicine CurrentSince Oct 10, 2002 Accepting new patients
Cep America - California Emergency Medicine CurrentSince Dec 1, 2012 Accepting new patients

Locations

751 Medical Center Ct
#1182
Chula Vista, CA 91911

2100 Powell St
Ste 900
Emeryville, CA 94608
Phone (510) 350-2777

1650 Creekside Dr
Folsom, CA 95630
Phone (916) 983-7400

12601 Garden Grove Blvd
Garden Grove, CA 92843
Phone (714) 537-5160

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

27300 Iris Ave
Moreno Valley, CA 92555
Phone (909) 243-0811

1150 N Indian Canyon Dr
Palm Springs, CA 92262
Phone (760) 323-6251

4445 Magnolia Ave
Riverside, CA 92501
Phone (800) 498-7156

1 Medical Plaza Dr
Roseville, CA 95661
Phone (916) 781-1000

Organizations & group practices 4

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.

Hospital & facility affiliations 2

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": "1151366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1730116385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4419",
            "city": "WOODLAND HILLS",
            "state": "CA",
            "postal_code": "913654419",
            "telephone_number": "800-506-6895",
            "fax_number": "818-587-2493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12401 WASHINGTON BLVD",
            "city": "WHITTIER",
            "state": "CA",
            "postal_code": "906021006",
            "telephone_number": "562-698-0811",
            "fax_number": "818-587-2493"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "JAIME",
        "middle_name": "E",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "A70475",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "00A704750",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00018956",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A704750",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Whittier, CA

Sources for this page

Verify at the official NPI Registry.