NPIMap

Individual provider Active NPI

Humberto Cesar Gonzalez Gonzalez, M.D

  • Gastroenterology Physician
  • Detroit, MI
National Provider Identifier
1043401086
Registry record updated Sep 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
4301089991 Issued in MI
Practice address
2799 W Grand Blvd
Detroit, MI 48202-2608
Phone
(139) 167-1783
NPI assigned
Aug 6, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 56890 MN
Gastroenterology Physician 207RG0100X 51261 TN
Transplant Hepatology Physician 207RT0003X 51261 TN
Gastroenterology Physician 207RG0100X 4301089991 MI Primary
Gastroenterology Physician 207RG0100X 107128 MN
Internal Medicine Physician 207R00000X 4301089991 MI

Addresses

Primary practice location

2799 W Grand Blvd
Detroit, MI 48202-2608

Mailing address

1 Ford PL Ste 3a
Detroit, MI 48202-3450
Phone (313) 874-4806

Other practice location 1

1265 Union Ave
Suite 184
Memphis, TN 38104-3415
Phone (901) 516-9183

Other identifiers 4

IdentifierTypeStateIssuer
6025474OtherTNBCBS
04122575MedicaidMS
206119001MedicaidAR
Q008639MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180611002904 MI Practitioner - GastroenterologyPractitioner - Internal Medicine 6608000575 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
GastroenterologyAlso: Internal Medicine
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Henry Ford Health SystemGroup PAC ID 0547178311, 2,550 clinicians

Practice addresses (Care Compare)

2799 W Grand Blvd
Detroit, MI 48202-2608
Phone (313) 916-2600

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Upper gastrointestinal (GI) endoscopy for acid reflux41

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
4301089991MIMDInternal Medicine Physician
56890MNMDGastroenterology Physician
51261TNMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Health System Current Accepting new patients
W. a. Foote Memorial Hospital, Inc Internal Medicine Current Accepting new patients
Henry Ford Health System CurrentSince May 1, 2018 Accepting new patients
W.a. Foote Memorial Hospital, Inc Gastroenterology CurrentSince Mar 18, 2024 Accepting new patients
W.a. Foote Memorial Hospital, Inc CurrentSince Mar 18, 2024 Accepting new patients
Henry Ford Health System Gastroenterology CurrentSince May 1, 2018 Accepting new patients
Ut Medical Group Inc Internal Medicine Past Accepting new patients

Locations

43281 Commons Dr
Clinton Twp, MI 48038
Phone (586) 263-6050

1 Ford Pl
Ste 3A
Detroit, MI 48202
Phone (313) 874-2892

2799 W Grand Blvd
#K7A6
Detroit, MI 48202

2799 W Grand Blvd
Detroit, MI 48202
Phone (313) 876-2062

1 Ford Pl
Ste 2E
Detroit, MI 48202
Phone (313) 874-3953

205 N East Ave
Jackson, MI 49201
Phone (517) 788-4730

813 W Michigan Ave
Jackson, MI 49202
Phone (517) 205-1000

39450 W Twelve Mile Rd
Novi, MI 48377
Phone (248) 344-0710

14500 Hall Rd
Sterling Hts, MI 48313
Phone (586) 247-2700

Interoperability endpoints

  • Direct secure messaging: hgonzalez13886@direct.hfhs.org

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1186358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695945600000",
    "number": "1043401086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 FORD PL STE 3A",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482023450",
            "telephone_number": "313-874-4806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2799 W GRAND BLVD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482022608",
            "telephone_number": "139-167-1783"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1265 Union Ave",
            "address_2": "Suite 184",
            "address_purpose": "LOCATION",
            "city": "Memphis",
            "state": "TN",
            "postal_code": "381043415",
            "country_code": "US",
            "telephone_number": "901-516-9183",
            "fax_number": "901-516-8993",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GONZALEZ GONZALEZ",
        "first_name": "HUMBERTO",
        "middle_name": "CESAR",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-06",
        "last_updated": "2023-09-29",
        "certification_date": "2023-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "MN",
            "license": "56890",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "TN",
            "license": "51261",
            "primary": false
        },
        {
            "code": "207RT0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Transplant Hepatology",
            "state": "TN",
            "license": "51261",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "MI",
            "license": "4301089991",
            "primary": true
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "MN",
            "license": "107128",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301089991",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "6025474",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04122575",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "206119001",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q008639",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.