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IDALISSE MARIE GONZALEZ MS
NPI 1053288456
Psychologist - Health Service in Isabela, PR

Active since October 20, 2025PECOS EnrolledAccepts Medicare Assignment
4972 AVE MILITAR, ISABELA, PR 00662(787) 365-0465 Get Directions Write a Review

NPPES record last updated: October 20, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Idalisse Marie Gonzalez Ms NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

IDALISSE MARIE GONZALEZ MS (NPI 1053288456) is an individual health service provider in Isabela, Puerto Rico, licensed in Puerto Rico (7545) and active in the NPI registry since October 2025. She is enrolled in Medicare PECOS and is a graduate of Other (2018).

NPPES Registry Identity

NPI1053288456
Entity TypeIndividualFemale
Primary Taxonomy103TH0100X
Provider Legal NameIDALISSE MARIE GONZALEZCredential: MS
Location Address4972 AVE MILITARIsabela, PR 00662-4163
Mailing Address4972 Ave MilitarIsabela, PR 00662-4163 · (787) 365-0465
Phone(787) 365-0465
Sole ProprietorYes
Medical School CMSOtherGraduated 2018
Enumeration DateOctober 20, 2025
NPPES CertifiedOctober 20, 2025
✔ NPI 1053288456 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · Health ServiceBehavioral Health & Social Service Providers
Taxonomy Code103TH0100X
License✔ Licensed in PR · 7545
Definition
A psychologist, certified/licensed at the independent practice level in his/her state, who is duly trained and experienced in the delivery of direct, preventative, assessment, and therapeutic intervention services to individuals whose growth, adjustment, or functioning is actually impaired or is demonstrably at high risk of impairment (1974).

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Idalisse Marie Gonzalez Ms is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID2062987290
PECOS Enrollment IDI20260406002890
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MARISELIS ORTIZ MALDONADO M.S.
Speech-Language Pathologist
4972 AVE MILITAR
ISABELA, PR 00662
Isabela Municipio (787) 365-0465
STEPHANIE MARIE VIERA SISCO M.A
Psychologist (Counseling)
4972 AVE MILITAR
ISABELA, PR 00662
Isabela Municipio (787) 365-0465
MR. EMMANUEL PADUA BORRERO MSSP
Psychologist
4972 AVE MILITAR
ISABELA, PR 00662
Isabela Municipio (787) 365-0465
MS. CLAUDIA SOFIA CRESPO SLPA
Specialist/Technologist (Speech-Language Assistant)
4972 AVE MILITAR
ISABELA, PR 00662
Isabela Municipio (787) 365-0465

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Idalisse Gonzalez's NPI number?

The NPI number for Idalisse Gonzalez is 1053288456. It was assigned to this individual provider in the NPPES registry on October 20, 2025.

Where is Idalisse Gonzalez located?

Idalisse Gonzalez practices at 4972 Ave Militar, Isabela, PR 00662. The listed phone number is (787) 365-0465.

What is Idalisse Gonzalez's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Health Service, with taxonomy code 103TH0100X.

Is Idalisse Gonzalez enrolled in Medicare?

Yes. Idalisse Gonzalez is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Idalisse Gonzalez was last updated on October 20, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.