Individual provider Active NPI

Carmen H Gonzalez, M.D.

  • Ophthalmology Physician
  • Lafayette, IN
National Provider Identifier
1730368846
Registry record updated Feb 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
01082957A Issued in IN
Practice address
2600 Greenbush St
Lafayette, IN 47904
Phone
(765) 448-8000
NPI assigned
Oct 25, 2007
Last updated
Feb 2, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 25MA08330200 NJ
Ophthalmology Physician 207W00000X 01082957A IN Primary

Addresses

Primary practice location

2600 Greenbush St
Lafayette, IN 47904

Mailing address

1200 W White River Blvd
Muncie, IN 47303-4988
Phone (877) 668-5621

Other practice location 1

571 Central Ave Ste 101
New Providence, NJ 07974
Phone (973) 763-2572

Other practice location 2

571 Central Ave Ste 101
New Providence, NJ 07974
Phone (973) 763-2572

Other practice location 3

403 Clifton Ave
Clifton, NJ 07011-2642
Phone (973) 767-2455

Other practice location 4

289 Monroe St
Passaic, NJ 07055-5209
Phone (973) 473-5151

Other identifiers 2

IdentifierTypeStateIssuer
300032069MedicaidIN
0160211MedicaidNJ

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address cgonzalez4@direct.iuhealth.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20191108002404 IN Practitioner - Ophthalmology 4587744123 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Iu Health Medical Group LLCGroup PAC ID 9638617913, 4,382 clinicians
Arnett Clinic LLCGroup PAC ID 0749184380, 401 clinicians

Practice addresses (Care Compare)

1701 N Senate Blvd
Indianapolis, IN 46202-1239
Phone (888) 484-3258

2600 Greenbush St
Lafayette, IN 47904-2477
Phone (765) 448-8000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.44 of 100Reported as individual
Quality
74.75
Promoting interoperability
97
Improvement activities
40
Cost
72.56

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery44

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Arnett Clinic, LLC Ophthalmology CurrentSince Nov 1, 2019 Accepting new patients
Arnett Clinic, LLC CurrentSince Nov 1, 2019 Accepting new patients
Arnett Clinic, LLC Current Accepting new patients
Iu Health Medical Group, LLC Past Accepting new patients

Locations

8016 Reliable Pkwy
Chicago, IL 60686

2600 Greenbush St
Lafayette, IN 47904

5165 McCarty Ln
Lafayette, IN 47905
Phone (800) 899-8448

1200 W White River Blvd
Muncie, IN 47303
Phone (765) 254-4009

Interoperability endpoints

  • Direct secure messaging: cgonzalez4@direct.iuhealth.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1193270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612224000000",
    "number": "1730368846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 W WHITE RIVER BLVD",
            "city": "MUNCIE",
            "state": "IN",
            "postal_code": "473034988",
            "telephone_number": "877-668-5621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 GREENBUSH ST",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "47904",
            "telephone_number": "765-448-8000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "571 Central Ave Ste 101",
            "address_purpose": "LOCATION",
            "city": "New Providence",
            "state": "NJ",
            "postal_code": "07974",
            "country_code": "US",
            "telephone_number": "973-763-2572",
            "fax_number": "973-762-9449",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "571 Central Ave Ste 101",
            "address_purpose": "LOCATION",
            "city": "New Providence",
            "state": "NJ",
            "postal_code": "07974",
            "country_code": "US",
            "telephone_number": "973-763-2572",
            "fax_number": "973-762-9449",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "403 Clifton Ave",
            "address_purpose": "LOCATION",
            "city": "Clifton",
            "state": "NJ",
            "postal_code": "070112642",
            "country_code": "US",
            "telephone_number": "973-767-2455",
            "fax_number": "973-767-2456",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "289 Monroe St",
            "address_purpose": "LOCATION",
            "city": "Passaic",
            "state": "NJ",
            "postal_code": "070555209",
            "country_code": "US",
            "telephone_number": "973-473-5151",
            "fax_number": "973-473-3331",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "CARMEN",
        "middle_name": "H",
        "name_prefix": "Mrs.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-25",
        "last_updated": "2021-02-02",
        "certification_date": "2021-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NJ",
            "license": "25MA08330200",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "IN",
            "license": "01082957A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300032069",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0160211",
            "state": "NJ"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cgonzalez4@direct.iuhealth.org",
            "affiliation": "N",
            "address_1": "2600 Greenbush St",
            "city": "Lafayette",
            "state": "IN",
            "country_code": "US",
            "postal_code": "47904",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lafayette, IN

Sources for this page

Verify at the official NPI Registry.