Individual provider Active NPI

Gonzalo Urbano, M.D.

  • Internal Medicine Physician
  • Clovis, CA
National Provider Identifier
1366538340
Registry record updated Aug 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
180174 Issued in NY
Practice address
2740 Herndon Ave
Clovis, CA 93611-6813
Phone
(559) 299-2578
NPI assigned
Oct 5, 2006
Last updated
Aug 6, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 6, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 180174 NY Primary

Addresses

Primary practice location

2740 Herndon Ave
Clovis, CA 93611-6813

Mailing address

2740 Herndon Ave
Clovis, CA 93611-6813
Phone (559) 299-2578

Other identifiers 7

IdentifierTypeStateIssuer
149379OtherNYWELLCARE HEALTH PLAN
180174-AIFOtherNYHEALTHFIRST
01237998MedicaidNY
040426028328OtherNYFIDELIS CARE
100087520001OtherNYUHC MEDICAID FHP
000330940101OtherNYHEALTH PLUS
180174POtherNYHEALTHCARE PARTNERS, INC. MEDICARE AND MEDICAID

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
I20210223003070 CA Practitioner - Internal Medicine 3072658236 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Central Valley Indian Health IncGroup PAC ID 9931092533, 33 clinicians

Practice addresses (Care Compare)

2740 Herndon Ave
Clovis, CA 93611-6813
Phone (559) 299-4264

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Central Valley Indian Health, Inc. CurrentSince Oct 23, 2024 Accepting new patients
Central Valley Indian Health, Inc Internal Medicine CurrentSince Oct 23, 2024 Accepting new patients
Central Valley Indian Health Inc Current Accepting new patients
Central Valley Indian Health Inc Past Accepting new patients

Locations

2740 Herndon Ave
Clovis, CA 93611
Phone (559) 299-2608

16835 Alkali Dr
Ste M
Lemoore, CA 93245
Phone (559) 924-0460

29369 Auberry Rd
Ste 102
Prather, CA 93651
Phone (559) 855-5390

Interoperability endpoints

  • Direct secure messaging: gurbano1040318@nychhc.direct-ci.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722902400000",
    "number": "1366538340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2740 HERNDON AVE",
            "city": "CLOVIS",
            "state": "CA",
            "postal_code": "936116813",
            "telephone_number": "559-299-2578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2740 HERNDON AVE",
            "city": "CLOVIS",
            "state": "CA",
            "postal_code": "936116813",
            "telephone_number": "559-299-2578"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "URBANO",
        "first_name": "GONZALO",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-05",
        "last_updated": "2024-08-06",
        "certification_date": "2021-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "180174",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE HEALTH PLAN",
            "identifier": "149379",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHFIRST",
            "identifier": "180174-AIF",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01237998",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIDELIS CARE",
            "identifier": "040426028328",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UHC MEDICAID FHP",
            "identifier": "100087520001",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PLUS",
            "identifier": "000330940101",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHCARE PARTNERS, INC. MEDICARE AND MEDICAID",
            "identifier": "180174P",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clovis, CA

Sources for this page

Verify at the official NPI Registry.