Mario Alberto Gonzalez, MSN/FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

95007892 Issued in CA

Practice address

651 N State St Ste 5
San Jacinto, CA 92583-6574

Phone

(951) 487-8506

NPI assigned

Oct 31, 2017

Last updated

Jun 23, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dap Health IncGroup PAC ID 6002989522, 67 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing, Nurse Practitioner

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: mario.gonzalez@49412312072196.direct.elationemr.com
• Direct secure messaging: mgonzalez@borregomedical.directbygreenway.com
• Direct secure messaging: mgonzalez684687@direct.ochin.org

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.

• Dap Health Inc.

  • Federally Qualified Health Center (FQHC)
  • Palm Springs, CA
  • NPI 1306464326
  Medicare reassignment Care Compare group
• Dap Health, Inc.

  dba DAP Health-Borrego Springs Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Borrego Springs, CA
  • NPI 1134144165

  Family Medicine

  NPD
• Eisenhower Medical Center

  dba Eisenhower Health

  • General Acute Care Hospital
  • Rancho Mirage, CA
  • NPI 1013981554
  NPD (past)

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

{
    "created_epoch": "1509408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624406400000",
    "number": "1740792795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27373 FAWN RIDGE CT",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928838413",
            "telephone_number": "562-278-4727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "651 N STATE ST STE 5",
            "city": "SAN JACINTO",
            "state": "CA",
            "postal_code": "925836574",
            "telephone_number": "951-487-8506"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11201 Barton St",
            "address_purpose": "LOCATION",
            "city": "Loma Linda",
            "state": "CA",
            "postal_code": "923576574",
            "country_code": "US",
            "telephone_number": "951-601-4406",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "MARIO",
        "middle_name": "ALBERTO",
        "credential": "MSN/FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-10-31",
        "last_updated": "2021-06-23",
        "certification_date": "2021-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95007892",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amanda D Gonzales, RADT
• Gabriela Gonzalez Vazquez
• Dianne Gonzalez
• Lorraine Anita Gonzalez
• Marina Gonzalez
• Monica Teresa Peterson Gordon, M.D.
• Ashleigh Gorgeous
• Virginia Nava Gradilla, CNA
• Grandeur Care Hospice LLC
• Khea Gray, LVN

• Family Nurse Practitioner in San Jacinto, CA
• Providers in San Jacinto, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.