RYAN A GONZALES (NPI# 1134330061) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134330061 |
| Entity Type | Individual |
| Full Name | RYAN A GONZALES |
| Credential | M.D. |
| Practice Address |
7910 W Jefferson Blvd Ste 108 Fort Wayne IN 46804-4159 |
| Practice Telephone | 2604848830 |
| Practice Fax Number | 2604831728 |
| Mailing Telephone | 2604848830 |
| Mailing Fax Number | 2604831728 |
| Enumeration Date | 2007-05-24 |
| Last Update Date | 2020-10-01 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RH0003X |
Internal Medicine Specialization: Hematology & Oncology |
01068203A | IN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | 0068624 | 05 | |
| IN | 200985860 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528601929 | Ryan Gonzales | Military Health Care Provider | 34800 Bob Wilson Dr, San Diego, CA 92134-1098 | 2019-10-18 |
| 1437639440 | Ryan Gonzales | Counselor | 2275 Arlington Dr, San Leandro, CA 94578 | 2018-08-19 |
| 1740736453 | Ryan Raquel Gonzales | Dentist | 1061 S State Route 260, Cottonwood, AZ 86326-4624 | 2016-09-01 |
| Street Address |
7910 W JEFFERSON BLVD STE 108 |
| City | FORT WAYNE |
| State | IN |
| Zip Code | 46804-4159 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073515987 | Praveen Kollipara | Internal Medicine | 7910 W Jefferson Blvd Ste 108, Fort Wayne, IN 46804-4159 | 2005-08-10 |
| 1831796762 | Tara Lynn Leland | Nurse Practitioner | 7910 W Jefferson Blvd Ste 108, Fort Wayne, IN 46804-4159 | 2020-10-05 |
| 1508330796 | Shelley D Seabolt | Nurse Practitioner | 7910 W Jefferson Blvd Ste 108, Fort Wayne, IN 46804-4159 | 2019-01-22 |
| 1265819064 | Guinevere M Nilles | Physician Assistant | 7910 W Jefferson Blvd Ste 108, Fort Wayne, IN 46804-4159 | 2015-04-30 |
| 1891968301 | Sunil Babu | Internal Medicine | 7910 W Jefferson Blvd Ste 108, Fort Wayne, IN 46804-4159 | 2008-04-04 |
| 1003012352 | Carrie Jean Boots | Nurse Practitioner | 7910 W Jefferson Blvd Ste 108, Fort Wayne, IN 46804-4159 | 2007-06-25 |
| 1861525560 | Ahad Ali Sadiq | Internal Medicine | 7910 W Jefferson Blvd Ste 108, Fort Wayne, IN 46804-4159 | 2007-03-13 |
| 1639148232 | David M Zimmerman | Internal Medicine | 7910 W Jefferson Blvd Ste 108, Fort Wayne, IN 46804-4159 | 2006-03-16 |
| 1831173269 | Yasolatha Nalamolu | Internal Medicine | 7910 W Jefferson Blvd Ste 108, Fort Wayne, IN 46804-4159 | 2005-11-30 |
| 1447252135 | Matthew L Carr | Internal Medicine | 7910 W Jefferson Blvd Ste 108, Fort Wayne, IN 46804-4159 | 2005-08-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396350344 | Derek Mumaw | Physical Therapist | 8420 Illinois Rd, Fort Wayne, IN 46804 | 2020-09-15 |
| 1942840228 | Erin M Mason | Behavior Technician | 5601 Coventry Ln, Fort Wayne, IN 46804 | 2020-01-14 |
| 1346880879 | Emily A Abdalla | Behavior Technician | 5601 Coventry Ln., Fort Wayne, IN 46804 | 2020-01-13 |
| 1083265433 | Fort Wayne Endodontics | Dentist | 9407 Illinois Rd, Fort Wayne, IN 46804 | 2019-09-26 |
| 1689140949 | Harrison Dental Group II, LLC | Dentist | 1333 Getz Rd, Fort Wayne, IN 46804 | 2018-10-15 |
| 1346731908 | Erin Nicole Zimmerman | Nurse Practitioner | 10170 Illinois Rd # 14, Fort Wayne, IN 46804 | 2018-05-19 |
| 1417446022 | Mary Harrington | Physical Therapist | 3320 Copper Hill Run, Fort Wayne, IN 46804 | 2018-05-09 |
| 1942701214 | Joshawa Todd Torres | Marriage & Family Therapist | 5651 Coventry Ln # 116, Fort Wayne, IN 46804 | 2018-02-22 |
| 1194235408 | Mitchell Kory Meyer | Specialist/Technologist | 9125 Yellow Tree Ct, Fort Wayne, IN 46804 | 2017-10-02 |
| 1902324916 | Emily Rene Sagstetter | Specialist/Technologist | 6034 Liberty Glade Ct, Fort Wayne, IN 46804 | 2017-08-30 |
| Find all providers in zip 46804 | ||||
| Taxonomy Code | 207RH0003X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Hematology & Oncology |
| An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2007. [7/1/2008: definiton added, source added; 7/1/2011: modified source] - Additional Resources: http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245232156 | Charles J Whalen | Internal Medicine | 2514 E Dupont Rd, Fort Wayne, IN 46825-1623 | 2005-08-10 |
| 1073515987 | Praveen Kollipara | Internal Medicine | 7910 W Jefferson Blvd Ste 108, Fort Wayne, IN 46804-4159 | 2005-08-10 |
| 1598766925 | Farrukh M Adhami | Internal Medicine | 2514 E Dupont Rd Ste 100, Fort Wayne, IN 46825-1619 | 2005-08-09 |
| 1396008918 | Michael J. Toole | Internal Medicine | 11050 Parkview Circle Dr, Fort Wayne, IN 46845-1739 | 2012-06-19 |
| 1245593854 | Melanie J. Clark | Internal Medicine | 11050 Parkview Circle Dr, Fort Wayne, IN 46845-1739 | 2012-06-19 |
| 1841581931 | Sarah Yue Wang | Internal Medicine | 11141 Parkview Plaza Dr Ste 305, Fort Wayne, IN 46845-1715 | 2011-04-25 |
| 1891968301 | Sunil Babu | Internal Medicine | 7910 W Jefferson Blvd Ste 108, Fort Wayne, IN 46804-4159 | 2008-04-04 |
| 1508835174 | Robert F Manges | Internal Medicine | 11050 Parkview Circle Dr, Fort Wayne, IN 46845 | 2006-03-16 |
| 1639148232 | David M Zimmerman | Internal Medicine | 7910 W Jefferson Blvd Ste 108, Fort Wayne, IN 46804-4159 | 2006-03-16 |
| 1831173269 | Yasolatha Nalamolu | Internal Medicine | 7910 W Jefferson Blvd Ste 108, Fort Wayne, IN 46804-4159 | 2005-11-30 |
| Find all providers in FORT WAYNE | ||||
| City | FORT WAYNE |
| Zip Code | 46804 |
Please comment or provide details below to improve the information on RYAN A GONZALES.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.