Individual provider Active NPI

Diego J Gonzalez, M.D.

  • Interventional Pain Medicine Physician
  • Albuquerque, NM
National Provider Identifier
1194715938
Registry record updated Apr 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
License
MD2004-0201 Issued in NM
Practice address
8300 Carmel Ave NE Ste 500-501
Albuquerque, NM 87122-3147
Phone
(505) 633-4141
Fax
(505) 633-4144
NPI assigned
Oct 24, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 2004-0201 NM
Pain Medicine (Anesthesiology) Physician 207LP2900X 2004-0201 NM
Interventional Pain Medicine Physician 208VP0014X MD2004-0201 NM Primary

Addresses

Primary practice location

8300 Carmel Ave NE Ste 500-501
Albuquerque, NM 87122-3147

Mailing address

8100 Wyoming Blvd NE # M4308
Albuquerque, NM 87113-1946
Phone (505) 633-4141

Other practice location 1

8100 Wyoming Blvd NE Ste M4
Albuquerque, NM 87113-1963
Phone (505) 727-7177

Other practice location 2

8300 Constitution Ave NE
Albuquerque, NM 87110-7613
Phone (505) 633-4141

Other practice location 3

1901 Red Rock Dr
Gallup, NM 87301-5683
Phone (505) 633-4141

Other practice location 4

101 Hospital Loop NE Ste 109
Albuquerque, NM 87109-2100
Phone (505) 966-4141

Other identifiers 1

IdentifierTypeStateIssuer
58830839MedicaidNM

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
I20040707000414 NM Practitioner - Pain ManagementPractitioner - Family PracticePractitioner - Anesthesiology 3274510284 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pain ManagementAlso: Anesthesiology, Family Practice
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Diego J Gonzalez MD PCGroup PAC ID 8527324367, 4 clinicians

Practice addresses (Care Compare)

101 Hospital Loop NE
Suite 109
Albuquerque, NM 87109-2100
Phone (505) 727-4400

Hospital & facility affiliations

  • Lovelace Women'S Hospital Hospital, Albuquerque, NM, CCN 320017
  • Lovelace Westside Hospital Hospital, Albuquerque, NM, CCN 320074

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2004-0201NMMDPain Medicine (Anesthesiology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Main Street Anesthesia of New Mexico, LLC Anesthesiology CurrentSince Jan 1, 2019 Accepting new patients
Rehoboth McKinley Christian Health Care Services, Inc Pain Medicine CurrentSince Dec 1, 2020 Accepting new patients
Rehoboth McKinley Christian Health Care Services, Inc. Interventional Pain Medicine Current Accepting new patients
Rehoboth McKinley Christian Health Care Services, Inc Family Medicine CurrentSince Dec 1, 2020 Accepting new patients
Diego J Gonzalez MD PC CurrentSince Jun 14, 2004 Accepting new patients
Diego Gonzalez MD PC Current Accepting new patients

Locations

4630 Jefferson Ln NE
Albuquerque, NM 87109
Phone (505) 361-1931

101 Hospital Loop NE
Ste 109
Albuquerque, NM 87109
Phone (505) 727-4400

8300 Carmel Ave NE
Ste 500501
Albuquerque, NM 87122
Phone (505) 633-4141

601 Martin Luther King Ave NE
Albuquerque, NM 87102
Phone (505) 727-8040

8100 Wyoming Blvd NE
Ste M4
Albuquerque, NM 87113
Phone (505) 301-1105

8300 Constitution Ave NE
Albuquerque, NM 87110
Phone (505) 291-2000

1901 Red Rock Dr
Gallup, NM 87301
Phone (505) 863-7000

117 E 19th St
Roswell, NM 88201
Phone (505) 727-2000

Interoperability endpoints

  • Direct secure messaging: dgonzalez16444@ahs.direct-ci.com

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 and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1130112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649894400000",
    "number": "1194715938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8100 WYOMING BLVD NE # M4308",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871131946",
            "telephone_number": "505-633-4141",
            "fax_number": "505-243-4804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8300 CARMEL AVE NE STE 500-501",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871223147",
            "telephone_number": "505-633-4141",
            "fax_number": "505-633-4144"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8100 Wyoming Blvd NE Ste M4",
            "address_purpose": "LOCATION",
            "city": "Albuquerque",
            "state": "NM",
            "postal_code": "871131963",
            "country_code": "US",
            "telephone_number": "505-727-7177",
            "fax_number": "505-727-3778",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8300 Constitution Ave NE",
            "address_purpose": "LOCATION",
            "city": "Albuquerque",
            "state": "NM",
            "postal_code": "871107613",
            "country_code": "US",
            "telephone_number": "505-633-4141",
            "fax_number": "505-633-4144",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1901 Red Rock Dr",
            "address_purpose": "LOCATION",
            "city": "Gallup",
            "state": "NM",
            "postal_code": "873015683",
            "country_code": "US",
            "telephone_number": "505-633-4141",
            "fax_number": "505-633-4144",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "101 Hospital Loop NE Ste 109",
            "address_purpose": "LOCATION",
            "city": "Albuquerque",
            "state": "NM",
            "postal_code": "871092100",
            "country_code": "US",
            "telephone_number": "505-966-4141",
            "fax_number": "505-633-4144",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "DIEGO",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-24",
        "last_updated": "2022-04-14",
        "certification_date": "2022-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NM",
            "license": "2004-0201",
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "NM",
            "license": "2004-0201",
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "NM",
            "license": "MD2004-0201",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "58830839",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.