Eddie Hernandez Gonzalez

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

95020273 Issued in CA

Practice address

12740 Hesperia Rd Ste B
Victorville, CA 92395-8306

Phone

(760) 713-6969

NPI assigned

Apr 1, 2022

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Razi Medical Group IncGroup PAC ID 1456580737, 8 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Providence St Mary Medical Center Hospital, Apple Valley, CA, CCN 050300
• Desert Valley Hospital Hospital, Victorville, CA, CCN 050709
• Victor Valley Global Medical Center Hospital, Victorville, CA, CCN 050517

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as individual

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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.

• Razi Medical Group Inc

  • Internal Medicine Physician
  • Victorville, CA
  • NPI 1295165645
  Medicare reassignment Care Compare group

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

• Desert Valley Hospital, LLC

  • General Acute Care Hospital
  • Victorville, CA
  • NPI 1851396576
  Care Compare affiliation
• St. Mary Medical Center

  • Advanced Practice Midwife
  • Apple Valley, CA
  • NPI 1043406440

  Hospital

  Care Compare affiliation
• St. Mary Medical Center

  • General Acute Care Hospital
  • Apple Valley, CA
  • NPI 1669456299
  Care Compare affiliation
• St. Mary Medical Center

  • General Acute Care Hospital
  • Apple Valley, CA
  • NPI 1710109186
  Care Compare affiliation
• Victor Valley Hospital Acquisition, Inc.

  • General Acute Care Hospital
  • Victorville, CA
  • NPI 1679879589
  Care Compare affiliation

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

{
    "created_epoch": "1648771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651968000000",
    "number": "1871234138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12740 HESPERIA RD STE B",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923958306",
            "telephone_number": "760-713-6969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12740 HESPERIA RD STE B",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923958306",
            "telephone_number": "760-713-6969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "EDDIE HERNANDEZ",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-04-01",
        "last_updated": "2022-05-08",
        "certification_date": "2022-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95020273",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ana Gonzalez
• Antoinette Elaine Gonzalez
• Cindy Gonzalez
• Destiny Gonzalez
• Deysy Alejandra Gonzalez
• Gabriela Guadalupe Gonzalez
• Josue Gonzalez
• Julian Gonzalez
• Kimberly Gonzalez
• Krystelina Gonzalez

• Family Nurse Practitioner in Victorville, CA
• Providers in Victorville, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.