Individual provider Active NPI

Vincent Gonzalez, M.D.

  • Pediatric Cardiology Physician
  • Omaha, NE
National Provider Identifier
1891115416
Registry record updated Jan 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Cardiology PhysicianTaxonomy code 2080P0202X
License
35668 Issued in NE
Practice address
8200 Dodge St
Omaha, NE 68114-4113
Phone
(402) 955-4350
Fax
(402) 955-4356
NPI assigned
Apr 22, 2014
Last updated
Jan 3, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Cardiology Physician 2080P0202X 35668 NE Primary
Pediatric Cardiology Physician 2080P0202X 14656 SD
Adult Congenital Heart Disease Physician 207RA0002X 35668 NE

Addresses

Primary practice location

8200 Dodge St
Omaha, NE 68114-4113

Mailing address

8200 Dodge St
Omaha, NE 68114-4113
Phone (402) 955-4350

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE
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
I20230926000619 NE Practitioner - Pediatric Medicine 6103044300 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Ohio State University College of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Unmc PhysiciansGroup PAC ID 6002728391, 1,490 clinicians

Practice addresses (Care Compare)

Emile 42ND St
Omaha, NE 68198-0001
Phone (402) 559-4015

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35668NEMDAdult Congenital Heart Disease Physician
14656SDMDPediatric Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Unmc Physicians CurrentSince Aug 13, 2023 Accepting new patients
Nebraska Pediatric Practice, Inc Past Accepting new patients

Locations

8200 Dodge St
Omaha, NE 68114
Phone (402) 955-4350

988102 Nebraska Medical Ctr
Omaha, NE 68198
Phone (402) 559-1010

Emile 42nd St
Omaha, NE 68198
Phone (402) 552-6731

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1398124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704240000000",
    "number": "1891115416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8200 DODGE ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681144113",
            "telephone_number": "402-955-4350",
            "fax_number": "402-955-4356"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8200 DODGE ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681144113",
            "telephone_number": "402-955-4350",
            "fax_number": "402-955-4356"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "VINCENT",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-22",
        "last_updated": "2024-01-03",
        "certification_date": "2023-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "NE",
            "license": "35668",
            "primary": true
        },
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "SD",
            "license": "14656",
            "primary": false
        },
        {
            "code": "207RA0002X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Adult Congenital Heart Disease",
            "state": "NE",
            "license": "35668",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.