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EZEKIEL GONZALEZ-FERNANDEZ
NPI 1538801212
Student in an Organized Health Care Education/Training Program in Jackson, MS

Active since April 12, 2022PECOS Enrolled
1921 PETIT BOIS ST N, JACKSON, MS 39211(716) 348-6067 Get Directions Write a Review

NPPES record last updated: April 12, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Ezekiel Gonzalez-fernandez NPPES

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

EZEKIEL GONZALEZ-FERNANDEZ (NPI 1538801212) is an individual student in an organized health care education/training program in Jackson, Mississippi and active in the NPI registry since April 2022. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1538801212
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameEZEKIEL GONZALEZ-FERNANDEZ
Location Address1921 PETIT BOIS ST NJackson, MS 39211-6708
Mailing Address1921 Petit Bois St NJackson, MS 39211-6708 · (716) 348-6067
Phone(716) 348-6067
Sole ProprietorNo
Enumeration DateApril 12, 2022
NPPES CertifiedApril 12, 2022
✔ NPI 1538801212 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
1921 PETIT BOIS ST N, Jackson, MS 39211
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Ezekiel Gonzalez-fernandez is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

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 Ezekiel Gonzalez-fernandez's NPI number?

The NPI number for Ezekiel Gonzalez-fernandez is 1538801212. It was assigned to this individual provider in the NPPES registry on April 12, 2022.

Where is Ezekiel Gonzalez-fernandez located?

Ezekiel Gonzalez-fernandez practices at 1921 Petit Bois St N, Jackson, MS 39211. The listed phone number is (716) 348-6067.

What is Ezekiel Gonzalez-fernandez's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Ezekiel Gonzalez-fernandez enrolled in Medicare?

Yes. Ezekiel Gonzalez-fernandez is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Ezekiel Gonzalez-fernandez was last updated on April 12, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years 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.