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ROBERTO RAUL GONZALEZ M.D.
NPI 1316197668
Family Medicine in Miami, FL

Active since September 23, 2008PECOS EnrolledAccepts Medicare Assignment
87.41/100
CMS Quality Rating
3850 W. FLAGLER ST., MIAMI, FL 33134(305) 774-3400(305) 442-0482 Get Directions Write a Review

NPPES record last updated: April 5, 2013. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Roberto Raul Gonzalez M.d. NPPES

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

ROBERTO RAUL GONZALEZ M.D. (NPI 1316197668) is an individual family medicine provider in Miami, Florida, licensed in Florida (ME114294) and active in the NPI registry since September 2008. He is enrolled in Medicare PECOS, is affiliated with Jackson Health System, and is a graduate of Other (2000).

NPPES Registry Identity

NPI1316197668
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameROBERTO RAUL GONZALEZCredential: M.D.
Location Address3850 W. FLAGLER ST.Miami, FL 33134-1604
Mailing Address3850 W. Flagler St.Miami, FL 33134-1604 · (305) 774-3400 · Fax (305) 442-0482
Phone(305) 774-3400
Fax(305) 442-0482
Sole ProprietorNo
Medical School CMSOtherGraduated 2000
Enumeration DateSeptember 23, 2008
Last NPPES UpdateApril 5, 2013
✔ NPI 1316197668 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Licenses✔ Licensed in FL · ME114294✔ Licensed in TN · 47075
Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X · License BP10028868 (TX)
3850 W. FLAGLER ST., Miami, FL 33134
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Superior HealthPlan, Ambetter Health, Ambetter of Alabama and more.Insurance ›

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

Roberto Raul Gonzalez M.d. 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 ID7911170717
PECOS Enrollment IDI20130405000387
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.

Areas of Expertise CMS Part B claims 2

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
52 services28 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
14 services12 patients

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Jackson Health System

Acute Care Hospitals · Miami, FL
1/5 CMS rating
OwnershipGovernment - Hospital District or Authority
CMS Certification Number100022
Location1611 NW 12th AveMiami, FL 33136 · Miami-Dade County
Emergency services Birthing friendly

Cleveland Clinic Martin North Hospital

Acute Care Hospitals · Stuart, FL
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number100044
Location200 SE Hospital AveStuart, FL 34994 · Martin County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 33134 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$96.13 typical visit price
range $60.92 – $187.05
Typical copayment $24.03 (range $15.23 – $46.76)
Most-billed visit code 99203
Established Patient
$107.17 typical visit price
range $18.99 – $150.24
Typical copayment $26.79 (range $4.74 – $37.56)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

87.41/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality80.73
Improvement Activities40
Cost60.03

Reported Quality Measures

Pneumococcal Vaccination Status for Older Adults
Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine
75%65 patients4/55-star benchmark: 100%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…
39%33 patients2/55-star benchmark: 100%
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims 3

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape B4035
Other-Enteral and Parenteral · category OB006N
2 suppliers12 claims360 services$4.98 avg. paid by Medicare
Enteral formula, nutritionally complete, calorically dense (equal to or greater than 1.5 kcal/ml) with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit B4152
Other-Enteral and Parenteral · category OB006N
2 suppliers12 claims6,704 services$0.25 avg. paid by Medicare
Standard wheelchair K0001
DME-Wheelchairs · category DD000N
1 supplier11 claims11 services$15.45 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES

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

JASON SHARMETT
Licensed Practical Nurse
3850 W. FLAGLER ST.
MIAMI, FL 33134
Miami-Dade County (305) 774-3334

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 Roberto Gonzalez's NPI number?

The NPI number for Roberto Gonzalez is 1316197668. It was assigned to this individual provider in the NPPES registry on September 23, 2008.

Where is Roberto Gonzalez located?

Roberto Gonzalez practices at 3850 W. Flagler St., Miami, FL 33134. The listed phone number is (305) 774-3400.

What is Roberto Gonzalez's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Roberto Gonzalez enrolled in Medicare?

Yes. Roberto 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.

What insurance does Roberto Gonzalez accept?

Health plans from Ambetter Health, Ambetter from Superior HealthPlan, Ambetter of Alabama, AmeriHealth Caritas Next and AvMed and 4 other insurers list Roberto Gonzalez as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Roberto Gonzalez affiliated with any hospitals?

According to CMS data, Roberto Gonzalez is affiliated with Jackson Health System and Cleveland Clinic Martin North Hospital.

When was this NPI record last updated?

The NPPES record for Roberto Gonzalez was last updated on April 5, 2013. NPI Profile syncs with the weekly NPPES data releases published by CMS.