Camilo Gonzalez Jr., M.D.
Individual provider Active NPI Internal Medicine Physician · Tohatchi, NM
NPI 1669869426 · NPPES record last updated Aug 17, 2021
Key facts
- NPI
- 1669869426
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- 73242-20 (WI)
- Practice address
- 07 Chooshgai Dr
Tohatchi Health Center
Tohatchi, NM 87325 - Phone
- (505) 733-8100
- Fax
- (505) 733-2384
- NPI assigned
- Apr 20, 2015
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Baylor College of Medicine, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- DHHS,PHS,Naihs, Gallup Indian Medical Center
Practice addresses (Care Compare)
007 Choosgai Dr
Tohatchi, NM 87325
Phone (505) 733-8413
Hospital & facility affiliations
- Gallup Indian Medical Center
- Rehoboth McKinley Christian Health Care Services
Merit-based Incentive Payment System (MIPS)
- Final score
- 78.18 of 100
- Quality
- 61.12
- Improvement activities
- 40
- Cost
- 81.87
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of nail tissue | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200826002220 | TX | Practitioner - Family Practice | 5193142800 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| DHHS,PHS,Naihs, Gallup Indian Medical Center | Current |
Accepting new patients |
Locations
516 E Nizhoni Blvd
Gallup, NM 87301
Phone (505) 722-1326
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Internal Medicine Physician | 207R00000X | 73242-20 | WI | Yes |
Addresses
Primary practice location
07 Chooshgai Dr
Tohatchi Health Center
Tohatchi, NM 87325
Mailing address
PO Box 142
Tohatchi, NM 87325-0142
Phone (505) 733-8100
Other providers in Tohatchi, NM
- DHHS, PHS, Naihs, Gallup Indian Medical Center
- Carrie Edsitty
- John Jerome Fagel
- Robert H Fernando
- Anna George
- Rolanda Hardy
- Georgia Ann Henry
- Lillian M Jones
- Valerie Joyce Leslie
- Sophina Mae Martin
All providers in Tohatchi, NM · Internal Medicine Physician in New Mexico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 17, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.