Individual provider Active NPI

John Anthony Gonzalez, M.D.

  • Obstetrics & Gynecology Physician
  • Crowley, LA
National Provider Identifier
1861490542
Registry record updated Jun 19, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
12939R Issued in LA
Practice address
527 Odd Fellows Rd Ste B
Crowley, LA 70526-2208
Phone
(337) 785-2006
Fax
(337) 785-2016
NPI assigned
Jul 7, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician 207VF0040X 12939R LA
Obstetrics & Gynecology Physician 207V00000X 12939R LA Primary

Addresses

Primary practice location

527 Odd Fellows Rd Ste B
Crowley, LA 70526-2208

Mailing address

3 Doris CT
Crowley, LA 70526-2363

Other identifiers 1

IdentifierTypeStateIssuer
1555011MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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
I20050210000408 LA Practitioner - Obstetrics/GynecologyPractitioner - Other (Physician) 2365494051 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
University of Miami, LM Miller School of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Acadia Women'S HealthGroup PAC ID 4789636481, 4 clinicians

Practice addresses (Care Compare)

527 Odd Fellows Rd
Suite B
Crowley, LA 70526-2208
Phone (337) 785-2006

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
12939RLAMDFemale Pelvic Medicine and Reconstructive Surgery (Obstetrics & Gynecology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Acadia Women'S Health CurrentSince Dec 23, 2002 Accepting new patients
Quentin D Romero MD Internal Medicine LLC Past Accepting new patients

Locations

1325 Wright Ave
Ste D
Crowley, LA 70526
Phone (337) 514-5181

527 Odd Fellows Rd
#B
Crowley, LA 70526
Phone (337) 327-8294

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.

Hospital & facility affiliations 1

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": "1120694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1497830400000",
    "number": "1861490542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 DORIS CT",
            "city": "CROWLEY",
            "state": "LA",
            "postal_code": "705262363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "527 ODD FELLOWS RD STE B",
            "city": "CROWLEY",
            "state": "LA",
            "postal_code": "705262208",
            "telephone_number": "337-785-2006",
            "fax_number": "337-785-2016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "JOHN",
        "middle_name": "ANTHONY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-07",
        "last_updated": "2017-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VF0040X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery",
            "state": "LA",
            "license": "12939R",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "LA",
            "license": "12939R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1555011",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Crowley, LA

Sources for this page

Verify at the official NPI Registry.