NPIMap

Individual provider Active NPI

Daniel Gonzalez, MD, MPH

  • Sports Medicine (Family Medicine) Physician
  • Santa Rosa, CA
National Provider Identifier
1861998650
Registry record updated Sep 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X
License
A177801 Issued in CA
Practice address
208 Concourse Blvd # 1
Santa Rosa, CA 95403-8210
Phone
(707) 544-3400
NPI assigned
Apr 2, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Sports Medicine (Family Medicine) Physician 207QS0010X A177801 CA Primary

Addresses

Primary practice location

208 Concourse Blvd # 1
Santa Rosa, CA 95403-8210

Mailing address

208 Concourse Blvd # 1
Santa Rosa, CA 95403-8210
Phone (707) 544-3400

Other practice location 1

Summa Health Sports Medicine
525 East Market Street
Akron, OH 44304
Phone (330) 379-5051

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20220715001691 CA Practitioner - Sports MedicinePractitioner - Family Practice 2961752365 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Sports MedicineAlso: Family Practice
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Redwood Orthopaedic Surgery Associates AMCGroup PAC ID 1850336157, 12 clinicians

Practice addresses (Care Compare)

208 Concourse Blvd
Suite 1
Santa Rosa, CA 95403-8210
Phone (707) 544-3400

Hospital & facility affiliations

  • Providence Santa Rosa Memorial Hospital Hospital, Santa Rosa, CA, CCN 050174
  • Healdsburg Hospital Hospital, Healdsburg, CA, CCN 051321
  • Adventist Health Clearlake Hospital, Clearlake, CA, CCN 051317
  • Adventist Health Ukiah Valley Hospital, Ukiah, CA, CCN 050301
  • Sonoma Valley Hospital Hospital, Sonoma, CA, CCN 050090

Merit-based Incentive Payment System (MIPS)

Final score
84.69 of 100Reported as group
Quality
72.71
Promoting interoperability
100
Improvement activities
40
Cost
76.27

Merit-based Incentive Payment System (MIPS)

Final score
91.9 of 100Reported as group
Quality
81.89
Promoting interoperability
99
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A177801CAMDSports Medicine (Family Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Santa Rosa Community Health Centers CurrentSince Dec 12, 2024 Accepting new patients
Santa Rosa Community Health Centers Current Accepting new patients
Redwood Orthopaedic Surgery Associates AMC CurrentSince Aug 15, 2022 Accepting new patients
Santa Rosa Community Health Centers CurrentSince Dec 12, 2024 Accepting new patients
St. Joseph Health Northern California, LLC Past Accepting new patients
Sutter Bay Hospitals Past Accepting new patients

Locations

3569 Round Barn Cir
Santa Rosa, CA 95403

208 Concourse Blvd
#1
Santa Rosa, CA 95403
Phone (707) 544-3400

Interoperability endpoints

  • Direct secure messaging: dgonzalez628764@hisp.ehr.sutterhealth.org

Organizations & group practices 6

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 6

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": "1522627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662422400000",
    "number": "1861998650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "208 CONCOURSE BLVD # 1",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954038210",
            "telephone_number": "707-544-3400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "208 CONCOURSE BLVD # 1",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954038210",
            "telephone_number": "707-544-3400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Summa Health Sports Medicine",
            "address_2": "525 East Market Street",
            "address_purpose": "LOCATION",
            "city": "Akron",
            "state": "OH",
            "postal_code": "44304",
            "country_code": "US",
            "telephone_number": "330-379-5051",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "DANIEL",
        "credential": "MD, MPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-02",
        "last_updated": "2022-09-06",
        "certification_date": "2022-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "CA",
            "license": "A177801",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Rosa, CA

Sources for this page

Verify at the official NPI Registry.