NPIMap

Individual provider Active NPI

Orrenzo Benally Snyder, M.D.

  • Urology Physician
  • Porterville, CA
National Provider Identifier
1720171259
Registry record updated Jul 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
C172411 Issued in CA
Practice address
263 Pearson Dr Ste 100
Porterville, CA 93257-3333
Phone
(559) 772-4301
Fax
(559) 772-4302
NPI assigned
Oct 2, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 29, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Urology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208800000X C172411 CA Primary
Urology Physician 208800000X 6844039-1205 UT

Addresses

Primary practice location

263 Pearson Dr Ste 100
Porterville, CA 93257-3333

Mailing address

263 Pearson Dr Ste 100
Porterville, CA 93257-3333
Phone (559) 772-4301

Other identifiers 2

IdentifierTypeStateIssuer
987349MedicaidAZ
100507194MedicaidNV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK, CA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20180510002536 OK Practitioner - Urology 3274431739 Reassigns benefits to 2 organizations
I20220301001309 CA Practitioner - Urology 3274431739

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

3201 W Gore Blvd
Suite 201
Lawton, OK 73505-6350
Phone (580) 357-2261

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C172411CAMDUrology Physician
6844039-1205UTMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Comanche County Healthcare Corporation Single Specialty CurrentSince Jul 9, 2024 Accepting new patients
Southwestern Surgical Affiliates, LLC Single Specialty CurrentSince May 1, 2018 Accepting new patients
Comanche County Healthcare Corp Single Specialty CurrentSince Jul 9, 2024 Accepting new patients
Comanche County Healthcare Corporation Single Specialty Current Accepting new patients
Alfaro LTD Single Specialty Past Accepting new patients
Jackson County Memorial Hospital Authority Single Specialty Past Accepting new patients
Granger Medical Specialists LLC Single Specialty Past Accepting new patients
Comanche County Hospital Authority Single Specialty Past Accepting new patients

Locations

3201 W Gore Blvd
Ste 300
Lawton, OK 73505
Phone (580) 248-5255

5602 SW Lee Blvd
Lawton, OK 73505
Phone (580) 531-4700

3201 W Gore Blvd
Ste 201
Lawton, OK 73505
Phone (580) 357-2261

5606 SW Lee Blvd
Ste 205
Lawton, OK 73505
Phone (580) 531-6465

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/1821/brand/1/csg/22/fhir/r4

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 4

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": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659052800000",
    "number": "1720171259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "263 PEARSON DR STE 100",
            "city": "PORTERVILLE",
            "state": "CA",
            "postal_code": "932573333",
            "telephone_number": "559-772-4301",
            "fax_number": "559-772-4302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "263 PEARSON DR STE 100",
            "city": "PORTERVILLE",
            "state": "CA",
            "postal_code": "932573333",
            "telephone_number": "559-772-4301",
            "fax_number": "559-772-4302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SNYDER",
        "first_name": "ORRENZO",
        "middle_name": "BENALLY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-02",
        "last_updated": "2022-07-29",
        "certification_date": "2022-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Urology",
            "state": "CA",
            "license": "C172411",
            "primary": true
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "UT",
            "license": "6844039-1205",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "987349",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100507194",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Porterville, CA

Sources for this page

Verify at the official NPI Registry.