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Export Provider Record NPI 1124087713
Fausto A GonzalezMD
Active
NPI Number1124087713
NPI TypeNPI-1 Individual
SpecialtyInternal Medicine
Provider Details
NPI1124087713
NPI TypeNPI-1 Individual
StatusActive
Enumeration Date2006-03-21
Last Updated2023-05-17
Mailing Address13405 Rockaway Blvd
South Ozone Park, NY 11420-3020
United States
Phone: (718) 323-9700 | Fax: (718) 323-0300
📍 View Map
Primary Practice Address13405 Rockaway Blvd
South Ozone Park, NY 11420-3020
United States
Phone: (718) 323-5500
📍 View Map
Other Identifiers
IssuerStateNumberOther Issuer
MEDICAIDNY0258138
Other (non-Medicare)NY2590034GHI PPO
Other (non-Medicare)NY286588WELLCARE
Taxonomy / Specialty
PrimaryTaxonomy Code & DescriptionStateLicense Number
Yes207R00000X – Internal MedicineNY229968-1
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About NPI 1124087713

Fausto A Gonzalez MD is a healthcare provider registered in the CMS NPPES NPI Registry with NPI number 1124087713. The primary specialty listed is Internal Medicine. The provider is located in South Ozone Park, NY. This NPI is classified as a Type 1 (Individual) NPI and is currently active. The NPI was first enumerated (assigned) on 2006-03-21. All data is sourced directly from the official CMS NPPES public API and is updated daily.

Frequently Asked Questions

What is NPI 1124087713?

NPI 1124087713 belongs to Fausto A Gonzalez MD, a Internal Medicine in South Ozone Park, NY. It is a Type 1 Individual NPI registered in the CMS NPPES NPI Registry.

Is NPI 1124087713 active?

The current status of NPI 1124087713 in the NPPES registry is Active. The record was last updated on 2023-05-17.

What specialty is NPI 1124087713?

NPI 1124087713 is classified under the taxonomy Internal Medicine. Taxonomy codes in NPPES are maintained by the National Uniform Claim Committee (NUCC) and identify the provider's type, classification, and specialization.

How do I verify NPI 1124087713?

You can verify NPI 1124087713 at the official CMS NPPES website at npiregistry.cms.hhs.gov or using our free NPI Lookup tool above. All data shown on this page is sourced directly from the official NPPES public API and is updated daily by CMS.

What address is on file for NPI 1124087713?

The primary practice address on file for NPI 1124087713 is 13405 Rockaway Blvd, South Ozone Park, NY 11420-3020. This address is registered in the NPPES system and providers are required to update it within 30 days of any change.

When was NPI 1124087713 issued?

NPI 1124087713 was first issued (enumerated) on 2006-03-21. The NPPES record was last updated on 2023-05-17.

Practice Location Map

Fausto A Gonzalez is located at 13405 Rockaway Blvd, South Ozone Park, NY. Use the map below to find directions or verify the practice location.

📍 13405 Rockaway Blvd, South Ozone Park, NY 11420-3020  ·  Open in Google Maps ↗

Related Healthcare Providers

The following providers share the same practice location, specialty, or state as Fausto A Gonzalez. All records sourced from the CMS NPPES registry.

License Information

The following state license numbers are on file in the NPPES registry for NPI 1124087713. For license status verification, contact the relevant state licensing board directly.

Specialty / TaxonomyLicense NumberState
Internal Medicine229968-1NY
Data Verified from CMS NPPES Last synced: 2026-06-29 · Source: npiregistry.cms.hhs.gov · 45 CFR Part 162