Active NPI
Ayezel Marina Munoz Gonzalez, MD
- Dermatology Physician
- Galveston, TX
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- License
- S4026
- Practice address
- 1005 Harborside Dr, FL 5
Galveston, TX 77555-0001 - Phone
- (409) 747-3376
- Fax
- (409) 772-4456
- NPI assigned
- Jun 27, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | TX | ||
| Dermatology Physician | 207N00000X | S4026 | TX | Primary |
Addresses
Primary practice location
1005 Harborside Dr, FL 5
Galveston, TX 77555-0001
Mailing address
PO Box 650859
Dept 710
Dallas, TX 75265-0859
Phone (409) 772-2222
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Dermatology
- Education
- Other, 2005
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1005 Harborside Dr FL
Suite 5
Galveston, TX 77555-0001
Phone (409) 772-6781
Hospital & facility affiliations
- University of Texas Medical Branch Galveston
Merit-based Incentive Payment System (MIPS)
- Final score
- 78.88 of 100
- Quality
- 73.38
- Improvement activities
- 40
- Cost
- 78.42
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Melanoma (skin cancer) excision | 1-10 |
| Removal of skin lesions | 279 |
| Removal of nail tissue | 1-10 |
| Skin biopsy | 129 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| S4026 | TX | MD | Dermatology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Utmb Faculty Group Practice | Dermatology | Current | Accepting new patients |
Locations
1005 Harborside Dr
Fl 5
Galveston, TX 77555
Phone (409) 747-3376
301 University Blvd
Galveston, TX 77555
Phone (409) 747-1883
2660 Gulf Fwy S
Ste A
League City, TX 77573
2660 Gulf Fwy S
League City, TX 77573
Phone (832) 505-2100
Interoperability endpoints
- amunozgonzalezmd47714@direct.utmb.edu
Organizations & group practices 1
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.
-
- General Acute Care Hospital
- Galveston, TX
- NPI 1548226988
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1498521600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1687392000000",
"number": "1780105056",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 650859",
"address_2": "DEPT 710",
"city": "DALLAS",
"state": "TX",
"postal_code": "752650859",
"telephone_number": "409-772-2222"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1005 HARBORSIDE DR, FL 5",
"city": "GALVESTON",
"state": "TX",
"postal_code": "775550001",
"telephone_number": "409-747-3376",
"fax_number": "409-772-4456"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MUNOZ GONZALEZ",
"first_name": "AYEZEL",
"middle_name": "MARINA",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-06-27",
"last_updated": "2023-06-22",
"certification_date": "2023-06-22",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "TX",
"license": null,
"primary": false
},
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "TX",
"license": "S4026",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Galveston, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2023; 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.