Alicja Katarzyna Gonzales, PHYSICIAN ASSISTANT

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA01067 Issued in OR

Practice address

202 NW 13TH Ave
Suite 300
Portland, OR 97209-2953

Phone

(503) 408-4078

Fax

(186) 685-9819

NPI assigned

May 19, 2006

Sex

Female

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 OR

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

Physician Assistant

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Peacehealth Networks on Demand LLCGroup PAC ID 1759731383, 197 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/30646/brand/1/csg/1/fhir/r4
• Direct secure messaging: alicja.gonzales.1@30646.direct.athenahealth.com

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.

• Peacehealth Networks on Demand, LLC

  • General Practice Physician
  • Tigard, OR
  • NPI 1023582178
  Medicare reassignment Care Compare group
• Hillsboro Urgent Care and Occupational Health

  • Family Medicine Physician
  • Hillsboro, OR
  • NPI 1255468179
  NPD (past)
• Zoomcare PC

  • Internal Medicine Physician
  • Portland, OR
  • NPI 1689647372
  NPD (past)
• Zoomcare Urgent Care LLC

  • Urgent Care Clinic/Center
  • Lake Oswego, OR
  • NPI 1376225813
  NPD (past)

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

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1246492800000",
    "number": "1760436372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3600 NW JOHN OLSEN PL",
            "address_2": "SUITE 250",
            "city": "HILLSBORO",
            "state": "OR",
            "postal_code": "971245815",
            "telephone_number": "503-684-8252",
            "fax_number": "186-685-9819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 NW 13TH AVE",
            "address_2": "SUITE 300",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972092953",
            "telephone_number": "503-408-4078",
            "fax_number": "186-685-9819"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALES",
        "first_name": "ALICJA",
        "middle_name": "KATARZYNA",
        "name_prefix": "Ms.",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-19",
        "last_updated": "2009-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "OR",
            "license": "PA01067",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lauren Gonia, RN
• Lyubov Luba Gonina, MA
• Hailey Anne Gonnerman
• Taylor Gonser
• Daria Gontar
• Breiana Nicole Gonzales
• Craig Romulo Gonzales, DC
• Danielle Gonzales
• David Gonzales, PHD
• Gabrielle Gonzales

• Medical Physician Assistant in Portland, OR
• Providers in Portland, OR by specialty
• Medical Physician Assistant in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2009; 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.