Active NPI
Roberto Gonzalez, M.D.
- Plastic Surgery Physician
- Altoona, PA
National Provider Identifier
1780607028
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Plastic Surgery Physician
- License
- MD428424
- Practice address
- 1414 9TH Ave
Station Medical Center
Altoona, PA 16602-2415 - Phone
- (814) 946-1655
- Fax
- (814) 949-7616
- NPI assigned
- Jul 26, 2006
- Last updated
- Apr 19, 2012
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Plastic Surgery Physician | 208200000X | MD428424 | PA | Primary |
Addresses
Primary practice location
1414 9TH Ave
Station Medical Center
Altoona, PA 16602-2415
Mailing address
1414 9TH Ave
Station Medical Center
Altoona, PA 16602-2415
Phone (814) 946-1655
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1556942 | Other | PA | GATEWAY HEALTH PLAN |
| 1016685350002 | Medicaid | PA | |
| 368970 | Other | PA | HIGHMARK BC BS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Windber Hospital, Inc. | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Windber Medical Center
- General Acute Care Hospital
- Windber, PA
- NPI 1275620536
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153872000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1334793600000",
"number": "1780607028",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1414 9TH AVE",
"address_2": "STATION MEDICAL CENTER",
"city": "ALTOONA",
"state": "PA",
"postal_code": "166022415",
"telephone_number": "814-946-1655",
"fax_number": "814-949-7616"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1414 9TH AVE",
"address_2": "STATION MEDICAL CENTER",
"city": "ALTOONA",
"state": "PA",
"postal_code": "166022415",
"telephone_number": "814-946-1655",
"fax_number": "814-949-7616"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GONZALEZ",
"first_name": "ROBERTO",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-26",
"last_updated": "2012-04-19",
"status": "A"
},
"taxonomies": [
{
"code": "208200000X",
"taxonomy_group": "",
"desc": "Plastic Surgery",
"state": "PA",
"license": "MD428424",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GATEWAY HEALTH PLAN",
"identifier": "1556942",
"state": "PA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1016685350002",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HIGHMARK BC BS",
"identifier": "368970",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Altoona, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.