Individual provider Active NPI

Luis Edwin Gaona Garza, MD

  • Family Medicine Physician
  • Rockford, IL
National Provider Identifier
1437735107
Registry record updated Sep 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036168560 Issued in IL
Practice address
815 Marchesano Dr
Rockford, IL 61102-3521
Phone
(779) 696-5950
NPI assigned
Mar 22, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 036.168560 IL
Family Medicine Physician 207Q00000X 036168560 IL Primary

Addresses

Primary practice location

815 Marchesano Dr
Rockford, IL 61102-3521

Mailing address

815 Marchesano Dr
Rockford, IL 61102-3521
Phone (779) 696-5950

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20241007000573 IL Practitioner - Family Practice 0446653141 Reassigns benefits to 1 organization

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
Swedishamerican HospitalGroup PAC ID 5799698346, 386 clinicians

Practice addresses (Care Compare)

815 Marchesano Dr
Rockford, IL 61102-3521
Phone (779) 696-5950

Hospital & facility affiliations

  • Uw Health Hospital, Rockford, IL, CCN 140228

Merit-based Incentive Payment System (MIPS)

Final score
81.51 of 100Reported as group
Quality
83.2
Promoting interoperability
77
Improvement activities
40
Cost
71.7

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036168560ILMDFamily Medicine Physician
036.168560ILMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Swedishamerican Hospital Family Medicine Current Accepting new patients
Swedishamerican Hospital CurrentSince Sep 17, 2024 Accepting new patients
Swedishamerican Hospital Family Medicine CurrentSince Sep 17, 2024 Accepting new patients

Locations

815 Marchesano Dr
Rockford, IL 61102
Phone (779) 696-5950

6824 Newburg Rd
Rockford, IL 61108
Phone (779) 696-7610

2550 Charles St
Rockford, IL 61108
Phone (779) 696-7285

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 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": "1616371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727222400000",
    "number": "1437735107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "815 MARCHESANO DR",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611023521",
            "telephone_number": "779-696-5950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "815 MARCHESANO DR",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611023521",
            "telephone_number": "779-696-5950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAONA GARZA",
        "first_name": "LUIS",
        "middle_name": "EDWIN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-22",
        "last_updated": "2024-09-25",
        "certification_date": "2024-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "IL",
            "license": "036.168560",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036168560",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockford, IL

Sources for this page

Verify at the official NPI Registry.