MR. JESSE GONZAGA NP
NPI 1649348921
Nurse Practitioner - Acute Care in Oakland, CA

Q: What is Jesse Gonzaga's NPI number?

The NPI number for Jesse Gonzaga is 1649348921. It was assigned to this individual provider in the NPPES registry on December 2, 2006.

Q: What is Jesse Gonzaga's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Acute Care, with taxonomy code 363LA2100X.

Q: When was this NPI record last updated?

The NPPES record for Jesse Gonzaga was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.

Active since December 02, 2006PECOS EnrolledAccepts Medicare Assignment

350 HAWTHORNE AVE, OAKLAND, CA 94609(510) 869-8660 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Mr. Jesse Gonzaga Np NPPES

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

MR. JESSE GONZAGA NP (NPI 1649348921) is an individual acute care provider in Oakland, California, licensed in California (11763) and active in the NPI registry since December 2006. He is enrolled in Medicare PECOS and is a graduate of Other (2000).

NPPES Registry Identity

NPI1649348921

Entity TypeIndividualMale

Primary Taxonomy363LA2100X

Provider Legal NameMR. JESSE GONZAGACredential: NP

Location Address350 HAWTHORNE AVEOakland, CA 94609-3108

Mailing Address3012 Summit St Fl 2Oakland, CA 94609-3480 · (510) 869-8660

Phone(510) 869-8660

Sole ProprietorYes

Medical School CMSOtherGraduated 2000

Enumeration DateDecember 2, 2006

Last NPPES UpdateJuly 8, 2007

✔ NPI 1649348921 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Acute CarePhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LA2100X

License✔ Licensed in CA · 11763

350 HAWTHORNE AVE, Oakland, CA 94609

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Other Identifiers 1

Medicare UPINP17840CA

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

Mr. Jesse Gonzaga Np 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 ID4082890348

PECOS Enrollment IDI20110520000572

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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 94609 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

$104.51 typical visit price

range $69.00 – $202.35

Typical copayment $26.12 (range $17.25 – $50.58)

Most-billed visit code 99203

Established Patient

$119.48 typical visit price

range $23.44 – $166.46

Typical copayment $29.87 (range $5.86 – $41.61)

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.

Other Providers at the Same Location NPPES 20

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

JEEVEN BRAH M.D.

Hospitalist

350 HAWTHORNE AVE, ROOM 2346
OAKLAND, CA 94609

Alameda County (510) 869-6883

BARBARA CHAN PT

Physical Therapist