Individual provider Active NPI

Maria Virginia Gonzaga, M.D.

  • Obstetrics & Gynecology Physician
  • Columbus, GA
National Provider Identifier
1730380916
Registry record updated Dec 26, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
70627 Issued in GA
Practice address
1900 10TH Ave
Suite 300
Columbus, GA 31901-3600
Phone
(706) 341-3311
Fax
(706) 341-3096
NPI assigned
May 29, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 26, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 70627 GA Primary

Addresses

Primary practice location

1900 10TH Ave
Suite 300
Columbus, GA 31901-3600

Mailing address

1900 10TH Ave
Suite 300
Columbus, GA 31901-3600
Phone (706) 341-3311

Other identifiers 1

IdentifierTypeStateIssuer
202I164305OtherGAMEDICARE PTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20140306002012 GA Practitioner - Obstetrics/Gynecology 7719136746 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Rutgers New Jersey Medical School, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Comprehensive Women'S Care of Columbus, P.C.Group PAC ID 2466678552, 3 clinicians

Practice addresses (Care Compare)

1900 10TH Ave
Suite 300
Columbus, GA 31901-3606
Phone (706) 341-3311

Hospital & facility affiliations

  • Piedmont Columbus Regional Midtown Hospital, Columbus, GA, CCN 110064

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
70627GAMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Comprehensive Women'S Care of Columbus, P.C. CurrentSince Jun 2, 2014 Accepting new patients
The Medical Center Inc Past Accepting new patients

Locations

1900 10th Ave
Ste 300
Columbus, GA 31901
Phone (706) 341-3311

Organizations & group practices 2

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 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": "1180396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1482710400000",
    "number": "1730380916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 10TH AVE",
            "address_2": "SUITE 300",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319013600",
            "telephone_number": "706-341-3311",
            "fax_number": "706-341-3096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 10TH AVE",
            "address_2": "SUITE 300",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319013600",
            "telephone_number": "706-341-3311",
            "fax_number": "706-341-3096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZAGA",
        "first_name": "MARIA",
        "middle_name": "VIRGINIA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-29",
        "last_updated": "2016-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "GA",
            "license": "70627",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "202I164305",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, GA

Sources for this page

Verify at the official NPI Registry.