NICOLE ELIZABETH GONZALEZ (MD) – Family Medicine Physician, NPI 1104206895

NICOLE ELIZABETH GONZALEZ (MD) is a healthcare provider. based in Brentwood, Tennessee. specializing in FAMILY PRACTICE. They hold the professional credentials MD. They hold a License No. R-10211 (IA). The NPI Number for NICOLE ELIZABETH GONZALEZ (MD) is 1104206895

Main info

Female
12 Years Of Experience
Accepts Medicare Assignment
Name
NICOLE ELIZABETH GONZALEZ (MD)
NPI
1104206895
Phone
(615) 371-4423
Address
5410 MARYLAND WAY STE 300
Enumeration Date
8 June 2015
Last Update Date
25 March 2019

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5208723000
Graduation Year
2014 (12 years ago)
PAC ID
2163738329
Group Practice PAC ID
0547560070
Professional Enrollment ID
I20190123001184
Address ID
AZ857452623TU1601XRDXX500
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience45
Completeness75
Years active:11State licenses:2Digital endpointsOther names

1,656 FAMILY PRACTICE in IA

Provider Addresses for NICOLE ELIZABETH GONZALEZ (MD)

  • 5410 MARYLAND WAY STE 300

    BRENTWOOD, TN 370275339

    Phone: (615) 371-4423

    Fax: (319) 272-2107

    Type: Mailing

  • 2055 KIMBALL AVE

    SUITE 101

    WATERLOO, IA 507025047

    Phone: (319) 272-2112

    Fax: (319) 272-2107

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2019-01-23

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20190123001184IFamily PracticeAZTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99233Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes250121$0
99239Hospital discharge day management, more than 30 minutes103101$0
99232Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes7649$0
99223Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes3939$0
View full utilization report →

Insurance plans in this area (ZIP 37027)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 0547560070View full group profile
NameSpecialtyState
Internal Medicine, Cardiovascular Disease (Cardiology)AZ
-AZ
Internal MedicineAZ
U R O L O G YNC
Nurse PractitionerAZ
Physician AssistantAZ
Family PracticeWV
Interventional Cardiology, Internal MedicineAZ
N E U R O L O G YAZ
-AZ

Reviews

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Frequently asked questions

Can I verify NICOLE ELIZABETH GONZALEZ (MD) with an NPI only?
You can start verification with NPI 1104206895 for NICOLE ELIZABETH GONZALEZ (MD), then check state licensing separately.
Does the file indicate NICOLE ELIZABETH GONZALEZ (MD) is practicing under active NPI?
Directory data currently reports NICOLE ELIZABETH GONZALEZ (MD) as active.
What healthcare role does NICOLE ELIZABETH GONZALEZ (MD) hold?
Scheduling teams often label NICOLE ELIZABETH GONZALEZ (MD) under Family Medicine Physician. Clinical services aligned with this taxonomy classification.
Does NICOLE ELIZABETH GONZALEZ (MD) list a practice location?
Patients near Brentwood, Tennessee may find NICOLE ELIZABETH GONZALEZ (MD) in results; validate coverage separately.
Why does NICOLE ELIZABETH GONZALEZ (MD) have multiple addresses?
2 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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