Individual provider Active NPI

Andrew Joseph Conlu, M.D.

  • Internal Medicine Physician
  • Gold Beach, OR
National Provider Identifier
1528018447
Registry record updated Jan 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
6600 Issued in NV
Practice address
94220 4TH St
Gold Beach, OR 97444-7756
Phone
(702) 813-1602
Fax
(702) 453-5741
NPI assigned
May 11, 2006
Last updated
Jan 18, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 18, 2023

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 6600 NV Primary

Addresses

Primary practice location

94220 4TH St
Gold Beach, OR 97444-7756

Mailing address

PO Box 230545
Las Vegas, NV 89105-0545
Phone (702) 813-1602

Other identifiers 1

IdentifierTypeStateIssuer
100502735MedicaidNV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV, OR2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20040512001094 NV Practitioner - HospitalistPractitioner - Internal Medicine 1557351673 Reassigns benefits to 2 organizations
I20140218000168 OR Practitioner - Internal Medicine 1557351673 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Curry Health District CurrentSince Oct 26, 2013 Accepting new patients
Humboldt General Hospital CurrentSince Feb 1, 2021 Accepting new patients
Humboldt General Hospital Current Accepting new patients
Curry Health District CurrentSince Oct 26, 2013 Accepting new patients
Humboldt General Hospital Internal Medicine CurrentSince Feb 1, 2021 Accepting new patients
Marisa C Medina MD PC Past Accepting new patients
Badar Anwar MD PC Past Accepting new patients

Locations

118 E Haskell St
Winnemucca, NV 89445
Phone (775) 623-5222

94220 4th St
Gold Beach, OR 97444
Phone (541) 247-3000

Interoperability endpoints

  • Direct secure messaging: andrew_conlu_md@yourcarecommunity.org

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, 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": "1147305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674000000000",
    "number": "1528018447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 230545",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891050545",
            "telephone_number": "702-813-1602",
            "fax_number": "702-453-5741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "94220 4TH ST",
            "city": "GOLD BEACH",
            "state": "OR",
            "postal_code": "974447756",
            "telephone_number": "702-813-1602",
            "fax_number": "702-453-5741"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONLU",
        "first_name": "ANDREW",
        "middle_name": "JOSEPH",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-11",
        "last_updated": "2023-01-18",
        "certification_date": "2023-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NV",
            "license": "6600",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100502735",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gold Beach, OR

Sources for this page

Verify at the official NPI Registry.