Individual provider Active NPI

Leslia F. Gonzalez, MD

  • Pediatrics Physician
  • Providence, RI
National Provider Identifier
1861059727
Registry record updated Dec 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD18421 Issued in RI
Practice address
355 Prairie Ave
Providence, RI 02905-1928
Phone
(401) 444-0570
Fax
(401) 444-0427
NPI assigned
May 24, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X LP04558 RI
Pediatrics Physician 208000000X MD18421 RI Primary

Addresses

Primary practice location

355 Prairie Ave
Providence, RI 02905-1928

Mailing address

375 Allens Ave
Providence, RI 02905-5010
Phone (401) 444-0400

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address lgonzalez59512@HCNetwork.direct-ci.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI
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
I20220906001629 RI Practitioner - Pediatric Medicine 1759615354 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
The Providence Community Health Centers, Inc CurrentSince Aug 15, 2022 Accepting new patients
The Providence Community Health Centers Inc. Past Accepting new patients

Locations

375 Allens Ave
Providence, RI 02905
Phone (401) 444-0400

Interoperability endpoints

  • Direct secure messaging: lgonzalez59512@hcnetwork.direct-ci.com

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1558656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702512000000",
    "number": "1861059727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "375 ALLENS AVE",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029055010",
            "telephone_number": "401-444-0400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "355 PRAIRIE AVE",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029051928",
            "telephone_number": "401-444-0570",
            "fax_number": "401-444-0427"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "LESLIA",
        "middle_name": "F.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-24",
        "last_updated": "2023-12-14",
        "certification_date": "2023-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "RI",
            "license": "LP04558",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "RI",
            "license": "MD18421",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lgonzalez59512@HCNetwork.direct-ci.com",
            "affiliation": "N",
            "address_1": "355 Prairie Ave",
            "city": "Providence",
            "state": "RI",
            "country_code": "US",
            "postal_code": "029051928",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Providence, RI

Sources for this page

Verify at the official NPI Registry.