Individual provider Active NPI

Gonzalo Alvarez del Real, MD

  • Allergy & Immunology Physician
  • Shreveport, LA
National Provider Identifier
1801853106
Registry record updated Feb 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy & Immunology PhysicianTaxonomy code 207K00000X
License
311897 Issued in LA
Practice address
1455 E Bert Kouns Industrial Loop # 108
Shreveport, LA 71105-5634
Phone
(318) 798-4544
Fax
(318) 798-4557
NPI assigned
Apr 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy & Immunology Physician 207K00000X 311897 LA Primary

Addresses

Primary practice location

1455 E Bert Kouns Industrial Loop # 108
Shreveport, LA 71105-5634

Mailing address

PO Box 415000 LBX 410604
Nashville, TN 37241-0604
Phone (318) 798-4539

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20190314002021 LA Practitioner - Allergy/ImmunologyPractitioner - Internal Medicine 1557365640 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Allergy/ImmunologyAlso: Internal Medicine
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Highland Clinic, a Prof Med CorpGroup PAC ID 3870493463, 60 clinicians

Practice addresses (Care Compare)

1455 E Bert Koun Loop
Shreveport, LA 71105-5634
Phone (318) 798-4539

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
78.6 of 100Reported as group
Quality
58.23
Promoting interoperability
97
Improvement activities
40
Cost
72.94

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
311897LAMDAllergy & Immunology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Highland Clinic, a Prof Med Corp CurrentSince Apr 1, 2019 Accepting new patients
Highland Clinic, a Prof Med Corp CurrentSince Apr 1, 2019 Accepting new patients
Taos Health Systems, Inc., Holy Cross Hospital Past Accepting new patients

Locations

5025 Shed Rd
Bossier City, LA 71111
Phone (318) 795-4741

1455 E Bert Kouns Industrial Loop
#108
Shreveport, LA 71105
Phone (318) 798-4544

1455 E Bert Kouns Industrial Loop
#L
Shreveport, LA 71105

1455 E Bert Kouns Industrial Loop
Ste 108
Shreveport, LA 71105
Phone (318) 798-4544

1455 E Bert Kouns Industrial Loop
Shreveport, LA 71105
Phone (318) 300-3643

Interoperability endpoints

  • Direct secure messaging: gonzalo.alvarezdelreal.p1@direct.hcapmc.nextgenshare.com

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 1

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": "1146182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551225600000",
    "number": "1801853106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 415000 LBX 410604",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372410604",
            "telephone_number": "318-798-4539",
            "fax_number": "318-798-4601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1455 E BERT KOUNS INDUSTRIAL LOOP # 108",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711055634",
            "telephone_number": "318-798-4544",
            "fax_number": "318-798-4557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALVAREZ DEL REAL",
        "first_name": "GONZALO",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-28",
        "last_updated": "2019-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "LA",
            "license": "311897",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shreveport, LA

Sources for this page

Verify at the official NPI Registry.