Active NPI
Doreen Gonzales
- Physical Therapist
- Albuquerque, NM
National Provider Identifier
1245629807
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 4342
- Practice address
- 9150 McMahon Blvd NW
Albuquerque, NM 87114-5201 - Phone
- (505) 898-7986
- NPI assigned
- Jan 20, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 4342 | NM | Primary |
Addresses
Primary practice location
9150 McMahon Blvd NW
Albuquerque, NM 87114-5201
Mailing address
9150 McMahon Blvd NW
Albuquerque, NM 87114
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4342 | NM | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1421712000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1622851200000",
"number": "1245629807",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9150 MCMAHON BLVD NW",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "87114"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9150 MCMAHON BLVD NW",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871145201",
"telephone_number": "505-898-7986"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GONZALES",
"first_name": "DOREEN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-01-20",
"last_updated": "2021-06-05",
"certification_date": "2021-06-05",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NM",
"license": "4342",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Albuquerque, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.