Individual provider Active NPI

Roberto Angel Gonzalez, DC

  • Chiropractor
  • Kahului, HI
National Provider Identifier
1790760957
Registry record updated Sep 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1484 Issued in HI
Practice address
360 Hoohana St Ste A104
Kahului, HI 96732-2975
Phone
(808) 866-9395
Fax
(808) 877-1558
NPI assigned
Dec 9, 2005
Last updated
Sep 24, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 24, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 31047 CA
Chiropractor 111N00000X 7045 AZ
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 1484 HI Primary

Addresses

Primary practice location

360 Hoohana St Ste A104
Kahului, HI 96732-2975

Mailing address

360 Hoohana St Ste A104
Kahului, HI 96732-2975
Phone (808) 866-9395

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211215000491 HI Practitioner - Chiropractic 8921998816 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aloha Family Chiropractic and Wellness LLCGroup PAC ID 0547651135, 2 clinicians

Practice addresses (Care Compare)

360 Hoohana St
Suite A104
Kahului, HI 96732-2975
Phone (808) 866-9437

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7045AZMDChiropractor
31047CAMDChiropractor
1484HIMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Aloha Family Chiropractic and Wellness LLC Chiropractor Current Accepting new patients
Aloha Family Chiropractic and Wellness LLC Chiropractor CurrentSince Oct 7, 2021 Accepting new patients
Hana Health Single Specialty CurrentSince Jun 1, 2024 Accepting new patients
Tiffany Lynn Naughton Chiropractor Past Accepting new patients
Lichtman Chiropractic Inc Chiropractor Past Accepting new patients
Bell Road Chiropractic and Wellness, LLC Chiropractor PastSince Feb 14, 2005 Accepting new patients
La Health & Wellness Medical Group PastSince Sep 15, 2017 Accepting new patients
Hana Health Single Specialty Past Accepting new patients

Locations

360 Hoohana St
Ste A104
Kahului, HI 96732
Phone (808) 866-9395

7 Aewa Pl
Ste 12
Makawao, HI 96768
Phone (808) 572-5599

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/9596/brand/1/csg/1/fhir/r4
  • Direct secure messaging: roberto.gonzalez.1@9596.direct.athenahealth.com

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1134086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632441600000",
    "number": "1790760957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 HOOHANA ST STE A104",
            "city": "KAHULUI",
            "state": "HI",
            "postal_code": "967322975",
            "telephone_number": "808-866-9395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 HOOHANA ST STE A104",
            "city": "KAHULUI",
            "state": "HI",
            "postal_code": "967322975",
            "telephone_number": "808-866-9395",
            "fax_number": "808-877-1558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "ROBERTO",
        "middle_name": "ANGEL",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-12-09",
        "last_updated": "2021-09-24",
        "certification_date": "2021-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "31047",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "AZ",
            "license": "7045",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "HI",
            "license": "1484",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kahului, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.

Verify at the official NPI Registry.