Ashley Brianne Gonzalez, CNM is a medicare enrolled "Advanced Practice Midwife" in Pleasant Grove, Utah. Her current practice location is
1886 W 800 N, Pleasant Grove, Utah. You can reach out to her office (for appointments etc.) via phone at
(801) 756-5288.
Ashley Brianne Gonzalez is licensed to practice in Utah (license number 8427268-4402) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1104538990.
Provider's Profile
| Full Name | Ashley Brianne Gonzalez |
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| Gender | Female |
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| Speciality | Advanced Practice Midwife |
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| Location | 1886 W 800 N, Pleasant Grove, Utah |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1104538990
- Provider Enumeration Date: 12/23/2022
- Last Update Date: 12/23/2022
Medicare PECOS Information:
- PECOS PAC ID: 7416329016
- Enrollment ID: I20230208000863
Medical Identifiers
Medical identifiers for Ashley Brianne Gonzalez such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
| 1104538990 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
| 367A00000X | Advanced Practice Midwife | 8427268-4402 (Utah) | 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. Ashley Brianne Gonzalez allows following entities to bill medicare on her behalf.
| Entity Name | Central Utah Clinic Pc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1093764805 PECOS PAC ID: 7517868508 Enrollment ID: O20040113000805 |
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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. Ashley Brianne Gonzalez 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 |
Ashley Brianne Gonzalez, CNM 1055 N. 500 W., Attn Credentialing, Provo, UT 84604 Ph: (801) 354-8225 | Ashley Brianne Gonzalez, CNM 1886 W 800 N, Pleasant Grove, UT 84062-4097 Ph: (801) 756-5288 |
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