NPIMap

Individual provider Active NPI

Gonzalo H Verdugo, MD

  • Otolaryngology Physician
  • Danvers, MA
National Provider Identifier
1841388436
Registry record updated Dec 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
A68261 Issued in CA
Practice address
104 Endicott St
Suite 100
Danvers, MA 01923-3623
Phone
(978) 745-6601
NPI assigned
Oct 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X A68261 CA Primary

Addresses

Primary practice location

104 Endicott St
Suite 100
Danvers, MA 01923-3623

Mailing address

104 Endicott St
Suite 100
Danvers, MA 01923-3623
Phone (978) 745-6601

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Verdugo.Gonzalo.NSENT@direct.partners.masshiway.net Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110707000457 MA Practitioner - Otolaryngology 8123911260 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Shore Ear, Nose and Throat Associates, PCGroup PAC ID 9032138367, 17 clinicians

Practice addresses (Care Compare)

104 Endicott St
Suite 100
Danvers, MA 01923-0009
Phone (978) 745-6601

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A68261CAMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore Ear, Nose & Throat Associates, PC Otolaryngology CurrentSince Jul 1, 2011 Accepting new patients
North Shore Ear, Nose & Throat Associates Otolaryngology Current Accepting new patients
Ritvik Mehta, MD Apc Otolaryngology PastSince Sep 11, 2019 Accepting new patients
Carlos F Jimenez, MD Otolaryngology Past Accepting new patients

Locations

100 Cummings Ctr
Ste 136G
Beverly, MA 01915

104 Endicott St
Ste 303
Danvers, MA 01923
Phone (978) 524-0050

104 Endicott St
Ste 100
Danvers, MA 01923
Phone (978) 745-6601

Interoperability endpoints

  • Direct secure messaging: verdugo.gonzalo.nsent@direct.partners.masshiway.net

Organizations & group practices 4

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 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640736000000",
    "number": "1841388436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 ENDICOTT ST",
            "address_2": "SUITE 100",
            "city": "DANVERS",
            "state": "MA",
            "postal_code": "019233623",
            "telephone_number": "978-745-6601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 ENDICOTT ST",
            "address_2": "SUITE 100",
            "city": "DANVERS",
            "state": "MA",
            "postal_code": "019233623",
            "telephone_number": "978-745-6601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VERDUGO",
        "first_name": "GONZALO",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-10",
        "last_updated": "2021-12-29",
        "certification_date": "2021-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "CA",
            "license": "A68261",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Verdugo.Gonzalo.NSENT@direct.partners.masshiway.net",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "104 Endicott St",
            "address_2": "Suite 100",
            "city": "Danvers",
            "state": "MA",
            "country_code": "US",
            "postal_code": "019233623",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Danvers, MA

Sources for this page

Verify at the official NPI Registry.