Vicente Mauricio Gonzaga, MD is a medicare enrolled "Psychiatry & Neurology - Psychiatry" physician in Tequesta, Florida. His current practice location is
11301 Se Tequesta Ter, Tequesta, Florida. You can reach out to his office (for appointments etc.) via phone at
(561) 744-0211.
Vicente Mauricio Gonzaga is licensed to practice in Indiana (license number 01072060A) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1437442555.
Physician's Profile
| Full Name | Vicente Mauricio Gonzaga |
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| Gender | Male |
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| Speciality | Psychiatry & Neurology - Psychiatry |
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| Location | 11301 Se Tequesta Ter, Tequesta, Florida |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1437442555
- Provider Enumeration Date: 05/23/2011
- Last Update Date: 02/11/2025
Medicare PECOS Information:
- PECOS PAC ID: 5799929543
- Enrollment ID: I20130917000182
Medical Identifiers
Medical identifiers for Vicente Mauricio Gonzaga such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1437442555 | NPI | - | NPPES |
| 201162750 | Medicaid | IN | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | C164167 (California) | Secondary |
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 01072060A (Indiana) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Vicente Mauricio Gonzaga allows following entities to bill medicare on his behalf.
| Entity Name | Indiana University Health Ball Memorial Physicians Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1235455544
PECOS PAC ID: 9537072640
Enrollment ID: O20031110000505 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Vicente Mauricio Gonzaga is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Vicente Mauricio Gonzaga, MD
11301 Se Tequesta Ter,
Tequesta, FL 33469-8146
Ph: () - | Vicente Mauricio Gonzaga, MD
11301 Se Tequesta Ter,
Tequesta, FL 33469-8146
Ph: (561) 744-0211 |
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