Active NPI
Jose E Gonzalez MD PA
- Pediatrics Physician
- Eldersburg, MD
National Provider Identifier
1780129023
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- Legal business name
- JOSE E GONZALEZ MD PA
- Practice address
- 1643 Liberty Rd Ste 106
Eldersburg, MD 21784-6545 - Phone
- (410) 795-4020
- Fax
- (410) 795-2733
- NPI assigned
- Dec 22, 2016
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Linda L Devilbiss
- Title
- Billing Manager
- Phone
- (410) 857-4844
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | Primary |
Addresses
Primary practice location
1643 Liberty Rd Ste 106
Eldersburg, MD 21784-6545
Mailing address
1643 Liberty Rd
Suite 106
Eldersburg, MD 21784-6545
Phone (410) 795-4020
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 390341900 | Medicaid | MD | |
| C57724 | Other | MD | UPIN |
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 21D2017698 | Jose E Gonzalez MD PA | Certificate of waiver | Dec 12, 2026 |
National Provider Directory
National Provider DirectoryLocations
1643 Liberty Rd
Ste 106
Eldersburg, MD 21784
Phone (410) 795-4020
Practitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Specialist
- Eldersburg, MD
- NPI 1346459757
-
- Family Nurse Practitioner
- Eldersburg, MD
- NPI 1669189692
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1482364800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1771545600000",
"number": "1780129023",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1643 LIBERTY RD",
"address_2": "SUITE 106",
"city": "ELDERSBURG",
"state": "MD",
"postal_code": "217846545",
"telephone_number": "410-795-4020",
"fax_number": "410-795-2733"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1643 LIBERTY RD STE 106",
"city": "ELDERSBURG",
"state": "MD",
"postal_code": "217846545",
"telephone_number": "410-795-4020",
"fax_number": "410-795-2733"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "JOSE E GONZALEZ MD PA",
"organizational_subpart": "NO",
"enumeration_date": "2016-12-22",
"last_updated": "2026-02-20",
"certification_date": "2026-02-20",
"status": "A",
"authorized_official_last_name": "DEVILBISS",
"authorized_official_first_name": "LINDA",
"authorized_official_middle_name": "L",
"authorized_official_title_or_position": "BILLING MANAGER",
"authorized_official_telephone_number": "410-857-4844"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Pediatrics",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "390341900",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UPIN",
"identifier": "C57724",
"state": "MD"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Eldersburg, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- 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.