Individual provider Active NPI

Hector Luis Santiago Gonzalez, MD

  • Nephrology Physician
  • Irving, TX
National Provider Identifier
1386191138
Registry record updated Jul 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
V0534 Issued in TX
Practice address
2005 W Park Dr Ste 200
Irving, TX 75061-2034
Phone
(214) 358-2300
Fax
(214) 579-6984
NPI assigned
Sep 8, 2016
Last updated
Jul 11, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X V0534 TX Primary

Addresses

Primary practice location

2005 W Park Dr Ste 200
Irving, TX 75061-2034

Mailing address

1505 LBJ Fwy Ste 700
Dallas, TX 75234-6065
Phone (214) 358-2300

Other practice location 1

2020 W State Highway 114 Ste 190
Grapevine, TX 76051-8649
Phone (214) 358-2300

Other practice location 2

925 E Southlake Blvd Ste 100
Southlake, TX 76092-1477
Phone (214) 358-2300

Other identifiers 1

IdentifierTypeStateIssuer
V0534OtherTXMEDICAL LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20240724000231 TX Practitioner - Nephrology 3375923295 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
Ponce School of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dallas Nephrology AssociatesGroup PAC ID 3870403819, 156 clinicians

Practice addresses (Care Compare)

2005 W Park Dr
Suite 200
Irving, TX 75061-2034
Phone (214) 358-2300

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
V0534TXMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dallas Nephrology Associates CurrentSince Sep 1, 2024 Accepting new patients
Dallas Nephrology Associates Nephrology CurrentSince Sep 1, 2024 Accepting new patients

Locations

1150 N Bishop Ave
Ste 100
Dallas, TX 75208
Phone (214) 956-8200

1505 Lyndon B Johnson Fwy
Ste 700
Dallas, TX 75234
Phone 21435823006012

1250 8th Ave
Ste 500
Ft Worth, TX 76104
Phone (817) 921-2153

2020 W State Highway 114
Ste 190
Grapevine, TX 76051
Phone 2143582300 ext. 6225

2005 W Park Dr
Ste 200
Irving, TX 75061
Phone (214) 366-6225

925 E Southlake Blvd
Ste 100
Southlake, TX 76092
Phone 2143582300 ext. 6225

Interoperability endpoints

  • Direct secure messaging: hsantiagogonzalez57444@direct.acumenmd.com
  • FHIR API: https://epicproxy.et1041.epichosted.com/FHIRProxy/api/FHIR/R4/

Organizations & group practices 2

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 4

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": "1473292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720656000000",
    "number": "1386191138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1505 LBJ FWY STE 700",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752346065",
            "telephone_number": "214-358-2300",
            "fax_number": "214-579-6941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2005 W PARK DR STE 200",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750612034",
            "telephone_number": "214-358-2300",
            "fax_number": "214-579-6984"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2020 W State Highway 114 Ste 190",
            "address_purpose": "LOCATION",
            "city": "Grapevine",
            "state": "TX",
            "postal_code": "760518649",
            "country_code": "US",
            "telephone_number": "214-358-2300",
            "fax_number": "214-579-6984",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "925 E Southlake Blvd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Southlake",
            "state": "TX",
            "postal_code": "760921477",
            "country_code": "US",
            "telephone_number": "214-358-2300",
            "fax_number": "214-579-6984",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SANTIAGO GONZALEZ",
        "first_name": "HECTOR",
        "middle_name": "LUIS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-09-08",
        "last_updated": "2024-07-11",
        "certification_date": "2024-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "TX",
            "license": "V0534",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "V0534",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Irving, TX

Sources for this page

Verify at the official NPI Registry.