Individual provider Active NPI

David A Gonzales, MD

  • Internal Medicine Physician
  • Albuquerque, NM
National Provider Identifier
1154326338
Registry record updated Jun 23, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
94-254 Issued in NM
Practice address
504 Elm St NE
Albuquerque, NM 87102-2512
Phone
(505) 724-2005
NPI assigned
Jun 15, 2005
Last updated
Jun 23, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 94-254 NM Primary
Hospitalist Physician 208M00000X 94-254 NM

Addresses

Primary practice location

504 Elm St NE
Albuquerque, NM 87102-2512

Mailing address

314 W Houghton St
Santa Fe, NM 87505-8849
Phone (505) 577-8282

Other identifiers 1

IdentifierTypeStateIssuer
15917MedicaidNM

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100817001622 NM Practitioner - Internal Medicine 7810982931 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Vincent HospitalGroup PAC ID 6608775135, 335 clinicians

Practice addresses (Care Compare)

455 Saint Michaels Dr
Santa Fe, NM 87505-7601
Phone (505) 913-6130

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
6380NMMDPharmacist
94-254NMMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St. Vincent Hospital CurrentSince Jun 13, 2019 Accepting new patients
St. Vincent Hospital Hospitalist CurrentSince Jun 13, 2019 Accepting new patients
St Vincent Hospital Current Accepting new patients
Monte Sol Medical Group Internal Medicine Past Accepting new patients
Milagro Medical Group PC Hospitalist PastSince Jul 25, 2002 Accepting new patients

Locations

455 Saint Michaels Dr
Santa Fe, NM 87505
Phone (505) 913-3361

455 Saint Michaels Dr
Ste 3201
Santa Fe, NM 87505
Phone (505) 989-6130

465 Saint Michaels Dr
Ste 200
Santa Fe, NM 87505
Phone (505) 995-4901

465 Saint Michaels Dr
Ste 200
Santa Fe, NM 87505
Phone (505) 995-4901

2211 Lomas Blvd NE
Unm, NM 87106
Phone (505) 272-1111

Interoperability endpoints

  • Direct secure messaging: dgonzales165367@christushealth.direct-ci.net

Organizations & group practices 6

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 1

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

NPI Registry JSON

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

{
    "created_epoch": "1118793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1308787200000",
    "number": "1154326338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "314 W HOUGHTON ST",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875058849",
            "telephone_number": "505-577-8282",
            "fax_number": "505-843-2931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "504 ELM ST NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871022512",
            "telephone_number": "505-724-2005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALES",
        "first_name": "DAVID",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-15",
        "last_updated": "2011-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NM",
            "license": "94-254",
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "NM",
            "license": "94-254",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "15917",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.