Autumn Marie Gonzales

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA2023-0240 Issued in NM

Practice address

3917 West Rd Ste a
Los Alamos, NM 87544-2292

Phone

(505) 661-8900

NPI assigned

Oct 9, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NM

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Medical Associates of Northern New MexicoGroup PAC ID 1557354339, 14 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Los Alamos Medical Center Hospital, Los Alamos, NM, CCN 320033
• Christus St Vincent Regional Medical Center Hospital, Santa Fe, NM, CCN 320002

Merit-based Incentive Payment System (MIPS)

Final score

89.11 of 100Reported as group

Quality

98.94

Promoting interoperability

81

Improvement activities

40

Cost

80.6

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/AAGADA

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

• Medical Associates of Northern New Mexico

  • Cardiovascular Disease Physician
  • Los Alamos, NM
  • NPI 1073501508

  Multi-Specialty

  Medicare reassignment Care Compare group NPD
• Taos Health Systems, Inc., Holy Cross Hospital

  • Critical Access Hospital
  • Taos, NM
  • NPI 1902338049
  NPD (past)

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

• PHC-Los Alamos Inc

  dba Los Alamos Medical Center

  • Rural Acute Care Hospital
  • Los Alamos, NM
  • NPI 1285701623
  Care Compare affiliation
• St Vincent Hospital

  dba CHRISTUS St. Vincent Regional Medical Center

  • General Acute Care Hospital
  • Santa Fe, NM
  • NPI 1578587150
  Care Compare affiliation

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

{
    "created_epoch": "1633737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691539200000",
    "number": "1073275756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3917 WEST RD STE A",
            "city": "LOS ALAMOS",
            "state": "NM",
            "postal_code": "875442292",
            "telephone_number": "505-661-8900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3917 WEST RD STE A",
            "city": "LOS ALAMOS",
            "state": "NM",
            "postal_code": "875442292",
            "telephone_number": "505-661-8900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1500 N Renaissance Blvd NE Ste C",
            "address_purpose": "LOCATION",
            "city": "Albuquerque",
            "state": "NM",
            "postal_code": "871077002",
            "country_code": "US",
            "telephone_number": "505-266-5565",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GONZALES",
        "first_name": "AUTUMN",
        "middle_name": "MARIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-10-09",
        "last_updated": "2023-08-09",
        "certification_date": "2023-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant, Medical",
            "state": "NM",
            "license": "PA2023-0240",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Susan M Gisler, CNP
• Dawn K Glover, DDS
• GLS Clinical Social Work LLC
• Laurence Goddard, MD
• Tina R Goldsmith, PH.D., BCBA-D
• Naomi Rae Gonzales
• Gonzalo a Diaz (Los Alamos)
• Patrice E Goodkind, MSW, LISW
• Brenna Graham
• Justin Green

• Medical Physician Assistant in Los Alamos, NM
• Providers in Los Alamos, NM by specialty
• Medical Physician Assistant in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.