Individual provider Active NPI

Ruby Gonzalez, M.D.

  • Family Medicine Physician
  • Glendora, CA
National Provider Identifier
1306226915
Registry record updated Feb 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A149561 Issued in CA
Practice address
440 W Foothill Blvd
Glendora, CA 91741-3361
Phone
(626) 963-9402
NPI assigned
Jun 9, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 1, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X A149561 CA Primary

Addresses

Primary practice location

440 W Foothill Blvd
Glendora, CA 91741-3361

Mailing address

440 W Foothill Blvd
Glendora, CA 91741-3361
Phone (626) 963-9402

Other practice location 1

800 N. Main Street
UCI Department of Family Medicine
Santa Ana, CA 92701
Phone (714) 480-2413

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190220002025 CA Practitioner - Family Practice 4385918473 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emanate Health Medical Care FoundationGroup PAC ID 9830544980, 85 clinicians

Practice addresses (Care Compare)

1115 S Sunset Ave
West Covina, CA 91790-3940

412 W Carroll Ave
Suite 108
Glendora, CA 91741-4707
Phone (626) 852-0411

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.36 of 100Reported as group
Quality
60.04
Promoting interoperability
87
Improvement activities
40
Cost
69.31

Merit-based Incentive Payment System (MIPS)

Final score
82.35 of 100Reported as group
Quality
52.92
Promoting interoperability
93
Improvement activities
40
Cost
70.76

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A149561CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emanate Health Medical Group Single Specialty CurrentSince Mar 1, 2019 Accepting new patients
Emanate Health Medical Care Foundation Single Specialty CurrentSince Jan 1, 2024 Accepting new patients
Emanate Health Medical Group Single Specialty Current Accepting new patients
Citrus Valley Physician Partners Single Specialty CurrentSince Mar 1, 2019 Accepting new patients

Locations

147 W College St
Covina, CA 91723
Phone (626) 332-2860

210 W San Bernardino Rd
Covina, CA 91723
Phone (626) 858-8580

440 W Foothill Blvd
Glendora, CA 91741
Phone (626) 963-9402

1115 S Sunset Ave
Ste 200
West Covina, CA 91790
Phone (626) 732-8390

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 4

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": "1433808000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706745600000",
    "number": "1306226915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "440 W FOOTHILL BLVD",
            "city": "GLENDORA",
            "state": "CA",
            "postal_code": "917413361",
            "telephone_number": "626-963-9402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "440 W FOOTHILL BLVD",
            "city": "GLENDORA",
            "state": "CA",
            "postal_code": "917413361",
            "telephone_number": "626-963-9402"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "800 N. Main Street",
            "address_2": "UCI Department of Family Medicine",
            "address_purpose": "LOCATION",
            "city": "Santa Ana",
            "state": "CA",
            "postal_code": "92701",
            "country_code": "US",
            "telephone_number": "714-480-2413",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "RUBY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-06-09",
        "last_updated": "2024-02-01",
        "certification_date": "2024-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A149561",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendora, CA

Sources for this page

Verify at the official NPI Registry.