NPIMap

Individual provider Active NPI

Adrian M Gonzalez, RPA-C

  • Medical Physician Assistant
  • Montour Falls, NY
National Provider Identifier
1962589572
Registry record updated Apr 30, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
007226 Issued in NY
Practice address
220 Steuben St
Montour Falls, NY 14865-9740
Phone
(607) 535-7121
NPI assigned
Nov 1, 2006
Last updated
Apr 30, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 007226 NY Primary

Addresses

Primary practice location

220 Steuben St
Montour Falls, NY 14865-9740

Mailing address

220 Steuben St
Montour Falls, NY 14865-9740
Phone (607) 535-7121

Other identifiers 1

IdentifierTypeStateIssuer
00359926MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20040910000488 NY Practitioner - Physician Assistant 6406823434 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
State University of New York at Stony Brook, School of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Associated Radiologists of the Finger Lakes PCGroup PAC ID 5294623955, 9 clinicians

Practice addresses (Care Compare)

5 Scotch Pine LN
Setauket, NY 11733-1044
Phone (607) 734-6237

600 Roe Ave
Elmira, NY 14905-1629
Phone (607) 737-4100

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
007226NYMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Arnot Ogden Medical Center Past Accepting new patients
Arnot Ogden Medical Center Medical Past Accepting new patients
Chemung Medical Services PC Past Accepting new patients
Fort Edward Rescue Squad Inc Past Accepting new patients
Atlantic Physician Services of Maryland, P.C. Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: agonzalez25179@direct.xtensys.com

Organizations & group practices 7

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": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1398816000000",
    "number": "1962589572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 STEUBEN ST",
            "city": "MONTOUR FALLS",
            "state": "NY",
            "postal_code": "148659740",
            "telephone_number": "607-535-7121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 STEUBEN ST",
            "city": "MONTOUR FALLS",
            "state": "NY",
            "postal_code": "148659740",
            "telephone_number": "607-535-7121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "ADRIAN",
        "middle_name": "M",
        "credential": "RPA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2014-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "007226",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00359926",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Montour Falls, NY

Sources for this page

Verify at the official NPI Registry.