Provider Type Icon

DR. GRANT WILSON GONZALEZ D.P.M. NPI 1164856704


NPI Information

NPI: 1164856704
Provider Name: DR. GRANT WILSON GONZALEZ, D.P.M.
Classification: Podiatrist - 213ES0103X
Entity Type: Individual

Specialization: Foot & Ankle Surgery

PECOS Registration: Yes

Address:
2921 MONTVALE DR
SPRINGFIELD, IL
ZIP 62704
Phone: (217) 787-2700
Get Directions

DR. Grant Wilson Gonzalez, D.P.M. is a foot and ankle surgery podiatrist in Springfield, IL with 12 years of experience. DR. Grant Wilson Gonzalez, D.P.M. NPI is 1164856704. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

2921 MONTVALE DR
SPRINGFIELD, IL
ZIP 62704-359
Phone: (217) 787-2700
Fax: (217) 787-2715

The NPI 1164856704 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA).

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Removal of tissue from 6 or more finger or toe nails (HCPCS:11721)
  • Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit (HCPCS:G0439)
  • Removal of skin and tissue first 20 sq cm or less (HCPCS:11042)
  • Removal of 2 to 4 thickened skin growths (HCPCS:11056)
  • X-ray of foot, minimum of 3 views (HCPCS:73630)
  • Removal of single thickened skin growth (HCPCS:11055)
  • Ultrasonic guidance imaging supervision and interpretation for insertion of needle (HCPCS:76942)
  • Removal of tissue from wounds per session (HCPCS:97597)
  • Destruction of up to 14 skin growths (HCPCS:17110)

The enumeration date for this NPI number is 8/31/2013 and was last updated on 3/7/2023.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1213ES0103XPodiatristFoot & Ankle SurgeryPOD001231GEORGIANo
2213ES0103XPodiatristFoot & Ankle Surgery016005651ILLINOISYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1016005651OTHERILLINOISSTATE OF ILLINOIS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.