NPIMap

Individual provider Active NPI

Carlos R. Gonzalez, M.D.

  • Nephrology Physician
  • Montebello, CA
National Provider Identifier
1891722369
Registry record updated Feb 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
A43562 Issued in CA
Practice address
3114 W Beverly Blvd
Montebello, CA 90640-2217
Phone
(323) 726-3868
Fax
(323) 726-3870
NPI assigned
Jun 28, 2006
Last updated
Feb 13, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X A43562 CA Primary

Addresses

Primary practice location

3114 W Beverly Blvd
Montebello, CA 90640-2217

Mailing address

2149 E Warner Rd Ste 102
Tempe, AZ 85284-3495
Phone (480) 393-0309

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070309000515 CA Practitioner - NephrologyPractitioner - Internal Medicine 3577501972 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
Other, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
L a County Nephrology Associates a Medical CorporationGroup PAC ID 3173566536, 11 clinicians

Practice addresses (Care Compare)

3114 W Beverly Blvd
Montebello, CA 90640-2217
Phone (323) 726-3868

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
98.44 of 100Reported as individual
Quality
78.98
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A43562CAMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
L a County Nephrology Associates a Medical Corporation CurrentSince May 23, 2024 Accepting new patients
Omega Medical Group Inc Nephrology Current Accepting new patients
Peritoneal Dialysis Center of America, Inc Current Accepting new patients

Locations

1720 E Cesar E Chavez Ave
Los Angeles, CA 90033
Phone (323) 260-5781

309 W Beverly Blvd
Montebello, CA 90640
Phone (323) 725-4209

3112 W Beverly Blvd
Montebello, CA 90640
Phone (323) 722-2053

3114 W Beverly Blvd
Montebello, CA 90640
Phone (323) 726-1317

16453 Colorado Ave
Paramount, CA 90723
Phone (562) 408-7427

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: carlos.gonzalez.1@16656.direct.athenahealth.com

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 13

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 13

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1151452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581552000000",
    "number": "1891722369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2149 E WARNER RD STE 102",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852843495",
            "telephone_number": "480-393-0309",
            "fax_number": "480-610-6189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3114 W BEVERLY BLVD",
            "city": "MONTEBELLO",
            "state": "CA",
            "postal_code": "906402217",
            "telephone_number": "323-726-3868",
            "fax_number": "323-726-3870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "CARLOS",
        "middle_name": "R.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-28",
        "last_updated": "2020-02-13",
        "certification_date": "2020-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "CA",
            "license": "A43562",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montebello, CA

Sources for this page

Verify at the official NPI Registry.