Individual provider Active NPI

Wilmer Augusto Palacios Gonzalez, NP

  • Nurse Practitioner
  • Fresno, CA
National Provider Identifier
1245913581
Registry record updated Sep 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
95026412 Issued in CA
Practice address
1187 E Herndon Ave Ste 101
Fresno, CA 93720-3166
Phone
(805) 630-7589
NPI assigned
Aug 11, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 95026412 CA Primary

Addresses

Primary practice location

1187 E Herndon Ave Ste 101
Fresno, CA 93720-3166

Mailing address

1187 E Herndon Ave Ste 101
Fresno, CA 93720-3166
Phone (559) 440-0450

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231004001120 CA Practitioner - Nurse Practitioner 8022462407 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1187 E Herndon Ave
Suite 101
Fresno, CA 93720-3166
Phone (559) 440-0450

Hospital & facility affiliations

  • Clovis Community Medical Center Hospital, Clovis, CA, CCN 050492
  • Community Regional Medical Center Hospital, Fresno, CA, CCN 050060
  • Saint Agnes Medical Center Hospital, Fresno, CA, CCN 050093

Merit-based Incentive Payment System (MIPS)

Final score
90.41 of 100Reported as group
Quality
87.02
Promoting interoperability
100
Improvement activities
40
Cost
78.21

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95026412CAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Community Foundation Medical Group CurrentSince Sep 1, 2023 Accepting new patients
Community Foundation Medical Group CurrentSince Sep 1, 2023 Accepting new patients
Community Foundation Medical Group Current Accepting new patients

Locations

1189 E Herndon Ave
Ste 101
Fresno, CA 93720
Phone (214) 906-4672

7095 N Chestnut Ave
Ste 101
Fresno, CA 93720
Phone (559) 323-8200

2335 E Kashian Ln
Ste 270
Fresno, CA 93701
Phone (559) 445-1251

1187 E Herndon Ave
Ste 101
Fresno, CA 93720
Phone (559) 440-0450

Organizations & group practices 3

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 3

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": "1691712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758326400000",
    "number": "1245913581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1187 E HERNDON AVE STE 101",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937203166",
            "telephone_number": "559-440-0450",
            "fax_number": "559-440-0460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1187 E HERNDON AVE STE 101",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937203166",
            "telephone_number": "805-630-7589"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALACIOS GONZALEZ",
        "first_name": "WILMER",
        "middle_name": "AUGUSTO",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-08-11",
        "last_updated": "2025-09-20",
        "certification_date": "2025-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95026412",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

Verify at the official NPI Registry.