Individual provider Active NPI

Daniel Gonzalez, M.D.

  • Sports Medicine (Family Medicine) Physician
  • Davie, FL
National Provider Identifier
1770037822
Registry record updated Oct 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X
License
ME143365 Issued in FL
Practice address
11050 Griffin Rd
Davie, FL 33328-3226
Phone
(786) 627-5162
NPI assigned
Aug 6, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2020

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Family Medicine) Physician 207QS0010X ME143365 FL Primary
Sports Medicine (Family Medicine) Physician 207QS0010X 83402 GA
Sports Medicine (Internal Medicine) Physician 207RS0010X 83402 GA
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

11050 Griffin Rd
Davie, FL 33328-3226

Mailing address

110 Rehill Ave
Somerville, NJ 08876-2519
Phone (908) 685-2899

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20200630000945 FL Practitioner - Sports MedicinePractitioner - Family Practice 4082943329 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Sports Medicine
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Holy Cross Hospital IncGroup PAC ID 1850298365, 299 clinicians

Practice addresses (Care Compare)

5597 N Dixie Hwy
Holy Cross Medical Group
Oakland Park, FL 33334-3406
Phone (954) 958-4800

Hospital & facility affiliations

  • Holy Cross Hospital Hospital, Ft Lauderdale, FL, CCN 100073
  • University Hospital and Medical Center Hospital, Tamarac, FL, CCN 100224

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Holy Cross Hospital Inc CurrentSince Jan 1, 2023 Accepting new patients
Holy Cross Hospital, Inc CurrentSince Jan 1, 2023 Accepting new patients

Locations

1309 S Federal Hwy
#G
Ft Lauderdale, FL 33316
Phone (954) 463-4383

5597 N Dixie Hwy
Fl 2
Oakland Park, FL 33334
Phone (954) 942-0321

5597 N Dixie Hwy
Oakland Park, FL 33334
Phone (954) 267-6390

Interoperability endpoints

  • Direct secure messaging: dgonzalez2611594@direct.trinity-health.org

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 5

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": "1470441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601942400000",
    "number": "1770037822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 REHILL AVE",
            "city": "SOMERVILLE",
            "state": "NJ",
            "postal_code": "088762519",
            "telephone_number": "908-685-2899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11050 GRIFFIN RD",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333283226",
            "telephone_number": "786-627-5162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "DANIEL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-08-06",
        "last_updated": "2020-10-06",
        "certification_date": "2020-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "FL",
            "license": "ME143365",
            "primary": true
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "GA",
            "license": "83402",
            "primary": false
        },
        {
            "code": "207RS0010X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Sports Medicine",
            "state": "GA",
            "license": "83402",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Davie, FL

Sources for this page

Verify at the official NPI Registry.