Kristen L Gonzales, MD
Individual provider Active NPI Family Medicine Physician · Evergreen, CO
NPI 1962420901 · NPPES record last updated Dec 28, 2018
Key facts
- NPI
- 1962420901
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 42179 (CO)
- Practice address
- 32135 Castle CT Ste 101
Evergreen, CO 80439 - Phone
- (303) 679-8500
- NPI assigned
- Jul 17, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CO
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040507000342 | CO | Practitioner - Family Practice | 0042209918 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 42179 | CO | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Conifer Medical Center, PC | Family Medicine | Current |
Accepting new patients |
| Cherry Creek Family Practice PLLC | Past | Accepting new patients | |
| New West Physicians Inc | Family Medicine | Past | Accepting new patients |
Locations
26659 Pleasant Park Rd
Conifer, CO 80433
Phone (303) 647-5300
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 42179 | CO | Yes |
Addresses
Primary practice location
32135 Castle CT Ste 101
Evergreen, CO 80439
Mailing address
32135 Castle CT Ste 101
Evergreen, CO 80439-8006
Phone (303) 679-8500
Other practice location 1
28000 Meadow Dr Unit 210
Evergreen, CO 80439-2116
Phone (303) 679-8500
Other providers in Evergreen, CO
- Lindsey Gilbert
- Sarah Eleanor Gillingham
- Juliet Joy Glass
- Valerie Jeanne Gluth
- Ryan Joseph Goff
- Maya Marie Gonzales
- Julie M Gordon
- Robert Scott Gordon
- Claire Gosnell
- Kelly Jeanne Grall
All providers in Evergreen, CO · Family Medicine Physician in Colorado
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 28, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.