BERNADETH TAGLE GONZALES (MD) – Family Medicine Physician, NPI 1104869429
Family Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
4,141 FAMILY PRACTICE in WA
Provider Addresses for BERNADETH TAGLE GONZALES (MD)
11603 State Ave
Suite G
Marysville, WA 982718465
Phone: (360) 658-6800
Fax: (360) 658-6819
Type: Location
3360, Southwest 87th Avenue, Raleigh West, Portland, Metro, Washington County, Oregon, 97225, United States
PORTLAND, OR 972083360
Phone: (866) 366-2983
Type: Mailing
11603, State Avenue, Kruse, Kruse Junction, Marysville, Snohomish County, Washington, 98271, United States
SUITE G
MARYSVILLE, WA 982718465
Phone: (360) 658-6800
Fax: (360) 658-6819
Type: Location
1909 214TH ST SE STE 300
BOTHELL, WA 980214418
Phone: (425) 412-7200
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 2 Open Payments records for all available years, with a total value of $31.
Total Amount is formed as General ($31) + Research ($0) + Ownership ($0) = $31.
Last reported payment date: 2023-06-02 • Largest payer in this snapshot: Corium, LLC ($31).
Total Amount
$31
General + Research + Ownership
Payments
2
Total payment records
General Amount
$31
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-06-02
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Corium, LLC | $31 |
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: 2007-10-30
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20071030000480 | I | Family Practice | WA | TBD |
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.
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
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 40 | 36 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 23 | 23 | $0 |
| G0008 | Administration of influenza virus vaccine | 16 | 16 | $0 |
| 90694 | Influenza vaccine, quadrivalent inactivated, 0.5 ml dosage | 14 | 14 | $0 |
Insurance plans in this area (ZIP 98271)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Clinical Social Worker | WA | |
| U R O L O G Y | WA | |
| Internal Medicine | MA | |
| U R O L O G Y | WA | |
| - | WA | |
| - | WA | |
| Family Practice | WA | |
| - | WA | |
| Internal Medicine | WA | |
| - | WA |
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