Individual provider Active NPI

Wilayneth Del Carmen Gonzalez, MD

  • Internal Medicine Physician
  • Woodstock, GA
National Provider Identifier
1942886510
Registry record updated Nov 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
97732 Issued in GA
Practice address
900 Towne Lake Pkwy Ste 410
Woodstock, GA 30189-1604
Phone
(678) 445-0819
Fax
(678) 445-0927
NPI assigned
Mar 23, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 97732 GA Primary

Addresses

Primary practice location

900 Towne Lake Pkwy Ste 410
Woodstock, GA 30189-1604

Mailing address

900 Towne Lake Pkwy Ste 410
Woodstock, GA 30189-1604
Phone (678) 445-0819

Other names 1

  • Wilayneth Del Carmen Rubistein Chavez Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20241018001944 GA Practitioner - Internal Medicine 6406244524 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

900 Towne Lake Pkwy
Suite 410
Woodstock, GA 30189-1604
Phone (678) 445-0819

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
97732GAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northside Primary Care Professional Services,LLC CurrentSince Sep 1, 2024 Accepting new patients
Northside Primary Care Professional Services, LLC CurrentSince Sep 1, 2024 Accepting new patients

Locations

1285 Upper Hembree Rd
Ste 205
Roswell, GA 30076
Phone (770) 521-1587

1000 Johnson Ferry Rd
Sandy Springs, GA 30342
Phone (404) 851-8737

3350 Paddocks Pkwy
Suwanee, GA 30024
Phone (678) 474-9633

900 Towne Lake Pkwy
Ste 410
Woodstock, GA 30189
Phone (678) 445-0819

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 5

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": "1616457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730851200000",
    "number": "1942886510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 TOWNE LAKE PKWY STE 410",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301891604",
            "telephone_number": "678-445-0819",
            "fax_number": "678-445-0927"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 TOWNE LAKE PKWY STE 410",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301891604",
            "telephone_number": "678-445-0819",
            "fax_number": "678-445-0927"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "WILAYNETH",
        "middle_name": "DEL CARMEN",
        "name_prefix": "Mrs.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-23",
        "last_updated": "2024-11-06",
        "certification_date": "2024-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "97732",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "WILAYNETH",
            "last_name": "RUBISTEIN CHAVEZ",
            "middle_name": "DEL CARMEN",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Woodstock, GA

Sources for this page

Verify at the official NPI Registry.