Jose Gonzalo Puente Moreno, MD
Individual provider Active NPI Family Medicine Physician · Tulare, CA
NPI 1992490544 · NPPES record last updated Apr 10, 2023
Key facts
- NPI
- 1992490544
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- P22 (CA)
- Practice address
- 1101 N Cherry St
Tulare, CA 93274-2231 - Phone
- (559) 686-9097
- Fax
- (559) 366-7060
- NPI assigned
- Apr 10, 2023
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 7
Hospital & facility affiliations 5
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Other, 2014
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Altura Centers for Health
Practice addresses (Care Compare)
1101 N Cherry St
Tulare, CA 93274-2231
Phone (559) 686-9097
Hospital & facility affiliations
- Omnia Healthcare, LLC
- Adventist Health Home Care Services
- Adventist Health Tulare
- Kaweah Health Medical Center
- Sierra View Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- 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 |
|---|---|---|---|---|
| I20230926002448 | CA | Practitioner - Family Practice | 4284088154 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Altura Centers for Health | Current |
Accepting new patients | |
| Altura Centers for Health | Current |
Accepting new patients | |
| Altura Centers for Health | Current | Accepting new patients |
Locations
1134 E Cartmill Ave
Tulare, CA 93274
Phone (559) 686-9097
1201 N Cherry St
Tulare, CA 93274
Phone (559) 685-4622
1101 N Cherry St
Tulare, CA 93274
Phone (559) 686-9097
Interoperability endpoints
- jose.puentemoreno.p1@direct.altura.nextgenshare.com
- https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | P22 | CA | Yes |
Addresses
Primary practice location
1101 N Cherry St
Tulare, CA 93274-2231
Mailing address
1201 N Cherry St
Tulare, CA 93274-2233
Phone (559) 686-9097
Other providers in Tulare, CA
- Precision Rehabilitation & Orthopedic Physical Therapy Inc
- Prem K. Kamboj, M.D.P.C.
- Bernadette Rodriguez Price
- Mary Ann Prickett
- Procare Medical Center, Inc.
- Selene Guadalupe Puentes Grajeda
- Pulmonary Critical Care and Sleep Disorders of Tulare PC
- Qian Qian
- Ernestina Quezada
- Amanda Dolores Quiroz
All providers in Tulare, CA · Family Medicine Physician in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 10, 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.