NPIMap

Individual provider Active NPI

Gustavo Urbina

  • Durable Medical Equipment & Medical Supplies
  • Kenosha, WI
National Provider Identifier
1497291116
Registry record updated Jan 19, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Practice address
4623 75TH St
Suite 279
Kenosha, WI 53142-3701
Phone
(773) 495-3796
NPI assigned
Jan 19, 2017
Last updated
Jan 19, 2017By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 19, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X Primary

Addresses

Primary practice location

4623 75TH St
Suite 279
Kenosha, WI 53142-3701

Mailing address

4623 75TH St
Suite 279
Kenosha, WI 53142-3701
Phone (773) 495-3796

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Allomed, Inc Durable Medical Equipment & Medical Supplies Current Accepting new patients
Flexus Medical Durable Medical Equipment & Medical Supplies Current Accepting new patients
VHW Medical Group LLC Current Accepting new patients

Locations

4623 75th St
Ste 279
Kenosha, WI 53142
Phone (773) 495-3796

Organizations & group practices 6

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1484784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484784000000",
    "number": "1497291116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4623 75TH ST",
            "address_2": "SUITE 279",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531423701",
            "telephone_number": "773-495-3796"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4623 75TH ST",
            "address_2": "SUITE 279",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531423701",
            "telephone_number": "773-495-3796"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "URBINA",
        "first_name": "GUSTAVO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-01-19",
        "last_updated": "2017-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kenosha, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.