Individual provider Active NPI

Scott V Gonzales, M.D.

  • Anesthesiology Physician
  • Worcester, MA
National Provider Identifier
1770573776
Registry record updated Mar 12, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
77725 Issued in MA
Practice address
55 Lake Ave N
Department of Anesthesiology
Worcester, MA 01655-0002
Phone
(508) 334-3271
Fax
(508) 856-5911
NPI assigned
Oct 21, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 77725 MA Primary

Addresses

Primary practice location

55 Lake Ave N
Department of Anesthesiology
Worcester, MA 01655-0002

Mailing address

53 Choate St
Essex, MA 01929-1047

Other identifiers 1

IdentifierTypeStateIssuer
3160556MedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, NY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20120905000247 MA Practitioner - Anesthesiology 0840362406 Reassigns benefits to 1 organization
I20260513000205 NY Practitioner - Anesthesiology 0840362406 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Harvard Medical School, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
JJM Medical Services PCGroup PAC ID 6800950312, 36 clinicians

Practice addresses (Care Compare)

1440 Main St
Waltham, MA 02451-1631
Phone (781) 891-9300

5 Johnson Rd
Latham, NY 12110-3096
Phone (518) 782-1181

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as apm
Quality
82.98
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
29.99 of 100Reported as individual
Quality
16.4
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
JJM Medical Services, PC Anesthesiology CurrentSince May 15, 2017 Accepting new patients
North American Partners in Anesthesia (Virginia), LLC Anesthesiology Past Accepting new patients
Anesthesia Healthcare Partners, Inc. Anesthesiology Past Accepting new patients

Locations

1440 Main St
Waltham, MA 02451
Phone (781) 891-9300

5 Johnson Rd
Latham, NY 12110
Phone (518) 767-0869

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1129852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1426118400000",
    "number": "1770573776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "53 CHOATE ST",
            "city": "ESSEX",
            "state": "MA",
            "postal_code": "019291047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 LAKE AVE N",
            "address_2": "DEPARTMENT OF ANESTHESIOLOGY",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016550002",
            "telephone_number": "508-334-3271",
            "fax_number": "508-856-5911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALES",
        "first_name": "SCOTT",
        "middle_name": "V",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-21",
        "last_updated": "2015-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MA",
            "license": "77725",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3160556",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Worcester, MA

Sources for this page

Verify at the official NPI Registry.