MR. HERMILO GONZALEZ JR. (NPI# 1023096153) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023096153 |
| Entity Type | Individual |
| Full Name | MR. HERMILO GONZALEZ JR. |
| Credential | MD |
| Practice Address |
497 W Lott St Buffalo WY 82834-1609 |
| Mailing Address |
497 West Lott Buffalo WY 82834-1609 |
| Practice Telephone | 3076842228 |
| Practice Fax Number | 3076842177 |
| Mailing Telephone | 3076842228 |
| Mailing Fax Number | 3076842177 |
| Enumeration Date | 2006-01-09 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 4374A | WY | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WY | BLUE CROSS | 306232 | 01 |
| WY | BLUE CROSS | 306039 | 01 |
| Street Address |
497 W LOTT ST |
| City | BUFFALO |
| State | WY |
| Zip Code | 82834-1609 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164427274 | Jeffery W Edstrom | Nurse Anesthetist, Certified Registered | 497 W Lott St, Buffalo, WY 82834-1658 | 2005-06-15 |
| 1700487865 | Savanah K Jackson | Dietitian, Registered | 497 W Lott St, Buffalo, WY 82834-1658 | 2020-11-05 |
| 1083044630 | Chelsea Puente | Physician Assistant | 497 W Lott St, Buffalo, WY 82834-1658 | 2013-11-18 |
| 1629364377 | Lisa Marie Mullen | Family Medicine | 497 W Lott St, Buffalo, WY 82834-1658 | 2011-06-21 |
| 1336229624 | Jennifer Ann Rice | Family Medicine | 497 W Lott St, Buffalo, WY 82834-1658 | 2006-10-17 |
| 1336128883 | Traci Denise Darnell | Physician Assistant | 497 W Lott St, Buffalo, WY 82834-1609 | 2006-01-12 |
| 1346228483 | Lawrence Edward Kirven | Family Medicine | 497 W Lott St, Buffalo, WY 82834-1609 | 2006-01-09 |
| 1316925456 | Aubrey Dozier Tabb | Family Medicine | 497 W Lott St, Buffalo, WY 82834-1609 | 2006-01-09 |
| 1306824446 | Grace Marie Gosar | Family Medicine | 497 W Lott St, Buffalo, WY 82834-1609 | 2006-01-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083993216 | Matthew Rick Raney | Dentist | 1001 Eagle View Drive, Buffalo, WY 82834 | 2011-08-05 |
| 1083881262 | Sandra K Ham | Nurse Practitioner | 107 W Hesse, Buffalo, WY 82834 | 2008-05-15 |
| 1366502726 | Cotant Family Dentistry, P.C. | Dental Hygienist | 112 High Street, Buffalo, WY 82834 | 2006-12-08 |
| 1487755823 | Jeanne Louise Peterson | Midwife | 30 Luna, Buffalo, SC 82834 | 2006-09-26 |
| 1902873193 | James Loren Johnson Jr. | Chiropractor | 963 Fort St, 4, Buffalo, WY 82834 | 2006-03-07 |
| 1043854888 | Wayne Kenneth Mcpherson Jr. | Marriage & Family Therapist | 512 W. Lott, Buffalo, WY 82834-1336 | 2019-11-05 |
| 1194248625 | Thales Christian Haskell | Dentist | 1001 Eagle View Dr, Buffalo, WY 82834-1417 | 2017-07-17 |
| 1528094158 | James Joseph Shubert | Dentist | 1001 Eagle View Dr, Buffalo, WY 82834-1422 | 2006-06-24 |
| 1457631558 | Eagle Summit Dental Clinic, Inc | Dentist | 1001 Eagle View Dr, Buffalo, WY 82834-1422 | 2011-08-19 |
| 1366719718 | Bidonde Family Practice, LLC | Nurse Practitioner | 107 W Hesse St, Buffalo, WY 82834-1501 | 2011-11-29 |
| Find all providers in zip 82834 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861002008 | Jenii Tia Statt | Family Medicine | 369 Washington St Apt 206, Buffalo, NY 14203-2116 | 2020-08-03 |
| 1023630738 | Alysia Mota Smith | Family Medicine | 610 N Hoy St, Buffalo, OK 73834-8933 | 2020-05-15 |
| 1568932945 | Team Excellence Health | Family Medicine | 1502 Niagara St Apt 604, Buffalo, NY 14213-1182 | 2018-11-28 |
| 1073992004 | Monument Health Network, Inc. | Family Medicine | 209 Ramsland St, Buffalo, SD 57720-0045 | 2015-05-22 |
| 1003222092 | Robinder Bahniwal | Family Medicine | 34 Benwood Avenue, Buffalo, NY 14215 | 2014-07-10 |
| 1245650308 | Maria Orellana-matta | Family Medicine | 900 Hertel Avenue, Buffalo, NY 14216 | 2014-04-16 |
| 1457686347 | Michael T. Doldan | Family Medicine | 2497 Delaware Ave, Buffalo, NY 14216-1712 | 2009-10-09 |
| 1740330851 | Buffalo Niagara Medical Associates | Family Medicine | 941 Washington St, Buffalo, NY 14203-1116 | 2007-01-11 |
| 1699799155 | Donald L Head | Family Medicine | 249 Craig St, Buffalo, TX 75831-7707 | 2006-07-27 |
| 1023031200 | Kirk A Scirto | Family Medicine | 184 Barton St, Buffalo, NY 14213-1573 | 2006-07-26 |
| Find all providers in BUFFALO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.