Individual provider Active NPI

Clayton F Runfalo, MD

  • Family Medicine Physician
  • Gonzales, LA
National Provider Identifier
1477895225
Registry record updated Mar 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD.208123 Issued in LA
Practice address
2400 S Burnside Ave
Gonzales, LA 70737-4645
Phone
(225) 709-2410
Fax
(225) 459-7064
NPI assigned
Mar 20, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD.208123 LA Primary

Addresses

Primary practice location

2400 S Burnside Ave
Gonzales, LA 70737-4645

Mailing address

2400 S Burnside Ave
Gonzales, LA 70737-4645
Phone (225) 709-2410

Other practice location 1

1702 N Burnside Ave Ste B
Gonzales, LA 70737-2141
Phone (225) 765-5500

Other practice location 2

7373 Perkins Rd
Baton Rouge, LA 70808-4326
Phone (225) 246-9997

Other practice location 3

7479 Perkins Rd
Baton Rouge, LA 70808
Phone (225) 246-9997

Other practice location 4

7479 Perkins Rd
Baton Rouge, LA 70808
Phone (225) 246-9997

Other practice location 5

7479 Perkins Rd
Baton Rouge, LA 70808
Phone (225) 246-9997

Other practice location 6

7479 Perkins Rd
Baton Rouge, LA 70808
Phone (225) 246-9997

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address crunfalo1048687@direct.casso.us.com Direct
FHIR URL https://epicproxy.et0830.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Other

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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
I20160210001423 LA Practitioner - Family Practice 9638473713 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Louisiana State University School of Medicine in New Orleans, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ochsner Clinic LLCGroup PAC ID 8224933619, 2,845 clinicians

Practice addresses (Care Compare)

17000 Medical Ctr Dr
Baton Rouge, LA 70816-3246
Phone (225) 761-5200

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD.208123LAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Convenient Care LLC CurrentSince Dec 28, 2015 Accepting new patients
Ochsner Clinic LLC CurrentSince May 19, 2022 Accepting new patients
Ochsner Clinic LLC CurrentSince May 19, 2022 Accepting new patients
Lake Urgent Care Ascension LLC CurrentSince Dec 28, 2015 Accepting new patients
Ochsner Clinic LLC Current Accepting new patients
Convenient Care LLC CurrentSince Dec 28, 2015 Accepting new patients
Convenient Care LLC Current Accepting new patients
Lake Urgent Care Ascension LLC Current Accepting new patients

Locations

17000 Medical Center Dr
Baton Rouge, LA 70816
Phone (225) 752-2470

3401 North Blvd
Ste 200
Baton Rouge, LA 70806
Phone (225) 336-3100

12525 Perkins Rd
#B
Baton Rouge, LA 70810
Phone (225) 819-8857

1702 N Burnside Ave
#C
Gonzales, LA 70737
Phone (225) 647-1850

2400 S Burnside Ave
Gonzales, LA 70737
Phone (225) 709-2410

1702 N Burnside Ave
#B
Gonzales, LA 70737
Phone (225) 647-8319

1702 N Burnside Ave
#A
Gonzales, LA 70737
Phone (225) 647-8319

1514 Jefferson Hwy
New Orleans, LA 70121

14350 Highway 73
Prairieville, LA 70769
Phone (225) 313-3930

104 Acadia Park Dr
Raceland, LA 70394
Phone (985) 537-3211

Organizations & group practices 8

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 2

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": "1363737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740960000000",
    "number": "1477895225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2400 S BURNSIDE AVE",
            "city": "GONZALES",
            "state": "LA",
            "postal_code": "707374645",
            "telephone_number": "225-709-2410",
            "fax_number": "225-459-7064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 S BURNSIDE AVE",
            "city": "GONZALES",
            "state": "LA",
            "postal_code": "707374645",
            "telephone_number": "225-709-2410",
            "fax_number": "225-459-7064"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1702 N Burnside Ave Ste B",
            "address_purpose": "LOCATION",
            "city": "Gonzales",
            "state": "LA",
            "postal_code": "707372141",
            "country_code": "US",
            "telephone_number": "225-765-5500",
            "fax_number": "225-647-2322",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7373 Perkins Rd",
            "address_purpose": "LOCATION",
            "city": "Baton Rouge",
            "state": "LA",
            "postal_code": "708084326",
            "country_code": "US",
            "telephone_number": "225-246-9997",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7479 Perkins Rd",
            "address_purpose": "LOCATION",
            "city": "Baton Rouge",
            "state": "LA",
            "postal_code": "70808",
            "country_code": "US",
            "telephone_number": "225-246-9997",
            "fax_number": "225-246-9116",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7479 Perkins Rd",
            "address_purpose": "LOCATION",
            "city": "Baton Rouge",
            "state": "LA",
            "postal_code": "70808",
            "country_code": "US",
            "telephone_number": "225-246-9997",
            "fax_number": "225-246-9116",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7479 Perkins Rd",
            "address_purpose": "LOCATION",
            "city": "Baton Rouge",
            "state": "LA",
            "postal_code": "70808",
            "country_code": "US",
            "telephone_number": "225-246-9997",
            "fax_number": "225-246-9116",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7479 Perkins Rd",
            "address_purpose": "LOCATION",
            "city": "Baton Rouge",
            "state": "LA",
            "postal_code": "70808",
            "country_code": "US",
            "telephone_number": "225-246-9997",
            "fax_number": "225-246-9116",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUNFALO",
        "first_name": "CLAYTON",
        "middle_name": "F",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-03-20",
        "last_updated": "2025-03-03",
        "certification_date": "2025-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "LA",
            "license": "MD.208123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "crunfalo1048687@direct.casso.us.com",
            "affiliation": "N",
            "endpointDescription": "FMOLHS-Epic",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "crunfalo1048687@direct.casso.us.com",
            "address_1": "1702 N Burnside Ave Ste B",
            "city": "Gonzales",
            "state": "LA",
            "country_code": "US",
            "postal_code": "707372141",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0830.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "FMOLHS FHIR URL",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "1702 N Burnside Ave Ste B",
            "city": "Gonzales",
            "state": "LA",
            "country_code": "US",
            "postal_code": "707372141",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Gonzales, LA

Sources for this page

Verify at the official NPI Registry.