Individual provider Active NPI

Selina Villarreal Gonzalez, NP

  • Family Nurse Practitioner
  • Yuma, AZ
National Provider Identifier
1760171904
Registry record updated Nov 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
221654 Issued in AZ
Practice address
1965 W 24TH St
Yuma, AZ 85364-6244
Phone
(928) 344-5774
NPI assigned
May 3, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 221654 AZ Primary

Addresses

Primary practice location

1965 W 24TH St
Yuma, AZ 85364-6244

Mailing address

2400 S Avenue a
Yuma, AZ 85364-7127
Phone (928) 344-2000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230523001893 AZ Practitioner - Nurse Practitioner 0345606059 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Yuma Regional Medical CenterGroup PAC ID 2062314826, 367 clinicians

Practice addresses (Care Compare)

1965 W 24TH St
Suite a
Yuma, AZ 85364-6255
Phone (928) 344-5774

Hospital & facility affiliations

  • Amedisys Home Health Home health agency, Yuma, AZ, CCN 037192
  • Enhabit Home Health Home health agency, Yuma, AZ, CCN 037280
  • Yuma Regional Medical Center Hospital, Yuma, AZ, CCN 030013

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Yuma Regional Medical Center CurrentSince Jun 4, 2023 Accepting new patients
Yuma Regional Medical Center CurrentSince Jun 4, 2023 Accepting new patients
Amb Medical, PLC PastSince May 7, 2023 Accepting new patients

Locations

1965 W 24th St
Yuma, AZ 85364
Phone (520) 317-1775

2400 S Avenue A
Yuma, AZ 85364
Phone (928) 336-7100

1965 W 24th St
Ste A
Yuma, AZ 85364
Phone (928) 344-5774

Organizations & group practices 3

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 3

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": "1683072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731542400000",
    "number": "1760171904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2400 S AVENUE A",
            "city": "YUMA",
            "state": "AZ",
            "postal_code": "853647127",
            "telephone_number": "928-344-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1965 W 24TH ST",
            "city": "YUMA",
            "state": "AZ",
            "postal_code": "853646244",
            "telephone_number": "928-344-5774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILLARREAL GONZALEZ",
        "first_name": "SELINA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-03",
        "last_updated": "2024-11-14",
        "certification_date": "2024-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "221654",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yuma, AZ

Sources for this page

Verify at the official NPI Registry.