Nestor Ruben Gonzalez, MD
Individual provider Active NPI Sports Medicine (Orthopaedic Surgery) Physician · Campbellsville, KY
NPI 1861522849 · NPPES record last updated May 9, 2023
Key facts
- NPI
- 1861522849
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X
- License
- 43819 (KY)
- Practice address
- 111 Well Park Lane
Ste 1
Campbellsville, KY 42718 - Phone
- (270) 692-3161
- Fax
- (270) 692-5155
- NPI assigned
- Mar 7, 2007
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 6
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Orthopedic Surgery
- Education
- Other, 1994
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Spring View Physician Practices LLC
Practice addresses (Care Compare)
111 Wellpark LN
Campbellsville, KY 42718-4924
Phone (270) 692-5254
Hospital & facility affiliations
- Spring View Hospital
- Taylor Regional Hospital
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Lower limb (leg) arthroscopy (minimally invasive joint repair) | 1-10 |
| Upper limb (arm) arthroscopy (minimally invasive joint repair) | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KY
- 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 |
|---|---|---|---|---|
| I20110114000251 | KY | Practitioner - Orthopedic Surgery | 5395934889 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11011414A | IN | MD | Student in an Organized Health Care Education/Training Program |
| FT335 | KY | MD | Student in an Organized Health Care Education/Training Program |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Taylor Regional Medical Group, LLC | Current |
Accepting new patients | |
| Taylor Regional Medical Group,LLC | Current | Accepting new patients | |
| Spring View Physician Practices, LLC | Current |
Accepting new patients | |
| Spring View Physician Practices LLC | Current |
Accepting new patients | |
| Taylor Regional Medical Group LLC | Current |
Accepting new patients | |
| Spring View Physician Practices, LLC | Past | Accepting new patients |
Locations
111 Wellpark Ln
Ste 1
Campbellsville, KY 42718
Phone (270) 692-3161
111 Wellpark Ln
Campbellsville, KY 42718
Phone (270) 692-5254
100 Medical Park Dr
Ste B
Campbellsville, KY 42718
Phone (270) 465-0632
111 Wellpark Ln
Ste 100
Campbellsville, KY 42718
1698 Old Lebanon Rd
Ste 3A
Campbellsville, KY 42718
Phone (270) 465-0632
1700 Old Lebanon Rd
Campbellsvlle, KY 42718
Phone (270) 465-3561
1698 Old Lebanon Rd
Campbellsvlle, KY 42718
Phone (270) 465-3561
420 N Loretto Rd
Lebanon, KY 40033
Phone (270) 321-4480
320 N Loretto Rd
Lebanon, KY 40033
Phone (270) 692-3161
420 N Loretto Rd
Ste 600
Lebanon, KY 40033
Phone (270) 692-5139
17 Lincoln Rdg
Springfield, KY 40069
Phone (270) 692-5272
Interoperability endpoints
- nestor.gonzalez.1@30070.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | 11011414A | IN | |
| Student in an Organized Health Care Education/Training Program | 390200000X | FT335 | KY | |
| Sports Medicine (Orthopaedic Surgery) Physician | 207XX0005X | 43819 | KY | Yes |
Addresses
Primary practice location
111 Well Park Lane
Ste 1
Campbellsville, KY 42718
Mailing address
320 N Loretto Rd
Lebanon, KY 40033-1300
Phone (270) 692-3161
Other practice location 1
320 N Loretto Rd
Lebanon, KY 40033-1300
Phone (270) 692-3161 ext. 757
Other practice location 2
420 N Loretto Rd Ste 600
Lebanon, KY 40033-1634
Phone (270) 692-5254
Other practice location 3
1698 Old Lebanon Rd
Suite 3A
Campbellsville, KY 42718-9662
Phone (270) 465-0632
Other providers in Campbellsville, KY
- Meredith H Gilpin
- Katelyn Neal Gist
- Amanda Goff
- Briana Goldsmith
- David Goldsmith
- Jacklyn Marie Goodson
- Kimberly A. Gowin
- Grace and Wellness Behavioral Health Group, LLC
- Heather Brook Graham
- Sandra Kaye Grant
All providers in Campbellsville, KY · Sports Medicine (Orthopaedic Surgery) Physician in Kentucky
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 9, 2023. 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.