Ashley Brianne Gonzalez, CNM is a medicare enrolled "Advanced Practice Midwife" in Pleasant Grove, Utah. Her current practice location is
1886 W 800 N, Pleasant Grove, Utah. You can reach out to her office (for appointments etc.) via phone at
(801) 756-5288.
Ashley Brianne Gonzalez is licensed to practice in Utah (license number 8427268-4402) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1104538990.
Provider's Profile
Full Name | Ashley Brianne Gonzalez |
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Gender | Female |
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Speciality | Advanced Practice Midwife |
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Location | 1886 W 800 N, Pleasant Grove, Utah |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1104538990
- Provider Enumeration Date: 12/23/2022
- Last Update Date: 12/23/2022
Medicare PECOS Information:
- PECOS PAC ID: 7416329016
- Enrollment ID: I20230208000863
Medical Identifiers
Medical identifiers for Ashley Brianne Gonzalez such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1104538990 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
367A00000X | Advanced Practice Midwife | 8427268-4402 (Utah) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Ashley Brianne Gonzalez allows following entities to bill medicare on her behalf.
Entity Name | Central Utah Clinic Pc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1093764805 PECOS PAC ID: 7517868508 Enrollment ID: O20040113000805 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Ashley Brianne Gonzalez is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Ashley Brianne Gonzalez, CNM 1055 N. 500 W., Attn Credentialing, Provo, UT 84604 Ph: (801) 354-8225 | Ashley Brianne Gonzalez, CNM 1886 W 800 N, Pleasant Grove, UT 84062-4097 Ph: (801) 756-5288 |
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