MR. GUSTAVO CALVILLO JR. APRN-CNP
NPI 1700417011
Nurse Practitioner - Family in Lake Jackson, TX

Q: What is Gustavo Calvillo's NPI number?

The NPI number for Gustavo Calvillo is 1700417011. It was assigned to this individual provider in the NPPES registry on January 27, 2020.

Q: What is Gustavo Calvillo's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Q: When was this NPI record last updated?

The NPPES record for Gustavo Calvillo was last updated on March 17, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since January 27, 2020PECOS EnrolledAccepts Medicare Assignment

229 PARKING WAY ST, LAKE JACKSON, TX 77566(979) 297-4066 Get Directions Write a Review

NPPES record last updated: March 17, 2025. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Mar 17, 2025, Sep 20, 2021, Aug 8, 2021 and 1 more (4 updates tracked since 2020).

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About Mr. Gustavo Calvillo Jr. Aprn-cnp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. GUSTAVO CALVILLO JR. APRN-CNP (NPI 1700417011) is an individual family provider in Lake Jackson, Texas, licensed in Texas (1019340) and active in the NPI registry since January 2020. He is enrolled in Medicare PECOS, is affiliated with Chi St Luke's Health Brazosport, and is a graduate of Other (2020).

NPPES Registry Identity

NPI1700417011

Entity TypeIndividualMale

Primary Taxonomy363LF0000X

Provider Legal NameMR. GUSTAVO CALVILLO JR.Credential: APRN-CNP

Location Address229 PARKING WAY STLake Jackson, TX 77566-5226

Mailing Address1123 Broadway St Ste BHouston, TX 77012-3711 · (832) 538-0974

Phone(979) 297-4066

Sole ProprietorNo

Medical School CMSOtherGraduated 2020

Enumeration DateJanuary 27, 2020

Last NPPES UpdateMarch 17, 20254 updates tracked since enumeration

NPPES CertifiedMarch 17, 2025

✔ NPI 1700417011 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

License✔ Licensed in TX · 1019340

229 PARKING WAY ST, Lake Jackson, TX 77566

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Other Names 1

Other Name (5)Gus Calvillo Aprn-cnp

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Community Health Choice.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Mr. Gustavo Calvillo Jr. Aprn-cnp is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID5698173391

PECOS Enrollment IDI20211011002533

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Chi St Luke's Health Brazosport

Acute Care Hospitals · Lake Jackson, TX

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number450072

Location100 Medical DriveLake Jackson, TX 77566 · Brazoria County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 77566 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$88.15 typical visit price

range $57.16 – $172.89

Typical copayment $22.03 (range $14.29 – $43.22)

Most-billed visit code 99203

Established Patient

$100.84 typical visit price

range $18.45 – $141.27

Typical copayment $25.21 (range $4.61 – $35.31)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. DAVID THURSTON BARR MD

Family Medicine