Ivan Claudio-Gonzalez

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

License

88721 Issued in GA

Practice address

601A Professional Dr
Suite 235
Lawrenceville, GA 30046-7697

Phone

(470) 292-3957

Fax

(470) 292-3683

NPI assigned

Jun 15, 2016

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nephrology

Education

Emory University School of Medicine, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Kidney Care Center Gwinnett LLCGroup PAC ID 0042544652, 4 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Hapeville Dialysis Center Dialysis facility, Hapeville, GA, CCN 112822
• Emory University Hospital Midtown Hospital, Atlanta, GA, CCN 110078
• Piedmont Hospital, Inc Hospital, Atlanta, GA, CCN 110083
• Emory Decatur Hospital Hospital, Decatur, GA, CCN 110076

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Kidney Care Center Gwinnett LLC

  • Nephrology Physician
  • Lawrenceville, GA
  • NPI 1487210316
  Medicare reassignment Care Compare group NPD
• South Fulton Dialysis Center LLC

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Atlanta, GA
  • NPI 1417016551
  NPD (past)

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

• Hapeville Dialysis Center LLC

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Hapeville, GA
  • NPI 1376777144

  Dialysis facility

  Care Compare affiliation Name & address match
• Crawford Long Hospital

  dba Emory University dba Emory Crawford Long Hospital

  • General Acute Care Hospital
  • Atlanta, GA
  • NPI 1144203563
  Care Compare affiliation
• Dekalb Medical Center, Inc.

  dba Emory Decatur Hospital

  • General Acute Care Hospital
  • Decatur, GA
  • NPI 1093716979
  Care Compare affiliation
• Piedmont Hospital, Inc

  dba Piedmont Hospital

  • General Acute Care Hospital
  • Atlanta, GA
  • NPI 1962461681
  Care Compare affiliation

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

{
    "created_epoch": "1465948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663200000000",
    "number": "1235589730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3877",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "604343877",
            "telephone_number": "815-714-7171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601A PROFESSIONAL DR",
            "address_2": "SUITE 235",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300467697",
            "telephone_number": "470-292-3957",
            "fax_number": "470-292-3683"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3268 Greenbriar Pkwy SW",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303312604",
            "country_code": "US",
            "telephone_number": "470-292-3957",
            "fax_number": "470-292-3683",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3660 Flat Shoals Rd Ste 250",
            "address_purpose": "LOCATION",
            "city": "Decatur",
            "state": "GA",
            "postal_code": "300341637",
            "country_code": "US",
            "telephone_number": "678-935-6090",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLAUDIO-GONZALEZ",
        "first_name": "IVAN",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-15",
        "last_updated": "2022-09-15",
        "certification_date": "2022-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "GA",
            "license": "88721",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelley Nichola Clark, CRNA
• Melinda Clark
• Shani Clark, MS SLP
• Stella Leigh Clark
• Classic Non Emergency Transportation (Bibi Aklima Ali)
• David Lewis Clay, PT, DPT, COMT
• Engle Clay, ALMFT
• Marlena Clayton
• Clear Choice Family Medicine, Inc
• Clearmind Psychiatry LLC

• Nephrology Physician in Lawrenceville, GA
• Providers in Lawrenceville, GA by specialty
• Nephrology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.