Individual provider Active NPI

John Winston Donato Gonzalez, M.D.

  • Psychiatry Physician
  • Terre Haute, IN
National Provider Identifier
1851471163
Registry record updated Apr 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
01045263 Issued in IN
Practice address
501 E Hospital LN
Suite 104
Terre Haute, IN 47802-4230
Phone
(812) 232-5518
Fax
(812) 235-8908
NPI assigned
Oct 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 01045263 IN Primary
Psychiatry Physician 2084P0800X 01052463A IN

Addresses

Primary practice location

501 E Hospital LN
Suite 104
Terre Haute, IN 47802-4230

Mailing address

501 E Hospital LN
Suite 104
Terre Haute, IN 47802-4230
Phone (812) 232-5518

Other identifiers 1

IdentifierTypeStateIssuer
200289950MedicaidIN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Johnwgonzalezmd.johngonzalez@144631.advancedmd-direct.com Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080429000709 IN Practitioner - Psychiatry 6305925504 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

501 E Hospital LN
Suite 104
Terre Haute, IN 47802-4230
Phone (812) 232-5518

Hospital & facility affiliations

  • Union Hospital Inc Hospital, Terre Haute, IN, CCN 150023

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01045263INMDPsychiatry Physician
01052463AINMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
John W. Gonzalez, MD Inc Psychiatry CurrentSince Apr 18, 2008 Accepting new patients

Locations

501 E Hospital Ln
Ste 104
Terre Haute, IN 47802
Phone (812) 232-5518

Interoperability endpoints

  • Direct secure messaging: johnwgonzalezmd.johngonzalez@144631.advancedmd-direct.com

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 2

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": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712620800000",
    "number": "1851471163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 E HOSPITAL LN",
            "address_2": "SUITE 104",
            "city": "TERRE HAUTE",
            "state": "IN",
            "postal_code": "478024230",
            "telephone_number": "812-232-5518",
            "fax_number": "812-235-8908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 E HOSPITAL LN",
            "address_2": "SUITE 104",
            "city": "TERRE HAUTE",
            "state": "IN",
            "postal_code": "478024230",
            "telephone_number": "812-232-5518",
            "fax_number": "812-235-8908"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "JOHN WINSTON",
        "middle_name": "DONATO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-17",
        "last_updated": "2024-04-09",
        "certification_date": "2024-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IN",
            "license": "01045263",
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IN",
            "license": "01052463A",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200289950",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Johnwgonzalezmd.johngonzalez@144631.advancedmd-direct.com",
            "affiliation": "N",
            "endpointDescription": "DM",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "501 E Hospital Ln",
            "address_2": "Suite 104",
            "city": "Terre Haute",
            "state": "IN",
            "country_code": "US",
            "postal_code": "478024230",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Terre Haute, IN

Sources for this page

Verify at the official NPI Registry.