Loretta Gonzales

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA2023-0232 Issued in NM

Practice address

10151 Montgomery Blvd NE BLDG 1
Albuquerque, NM 87111-3670

Phone

(505) 855-5503

Fax

(505) 855-5533

NPI assigned

Oct 22, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Group practices

Western Dermatology Consultants PCGroup PAC ID 4880777432, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Western Dermatology Consultants PC

  • MOHS-Micrographic Surgery Physician
  • Albuquerque, NM
  • NPI 1174653299
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1634860800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760659200000",
    "number": "1356005680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10151 MONTGOMERY BLVD NE BLDG 1",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871113670",
            "telephone_number": "505-855-5503",
            "fax_number": "505-855-5533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10151 MONTGOMERY BLVD NE BLDG 1",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871113670",
            "telephone_number": "505-855-5503",
            "fax_number": "505-855-5533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALES",
        "first_name": "LORETTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-10-22",
        "last_updated": "2025-10-17",
        "certification_date": "2025-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NM",
            "license": "PA2023-0232",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "PA2023-0232",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kim Gonzales
• Kristen M. Gonzales, M.D.
• Krystyna Gonzales
• Lawanda Gonzales
• Lisa Gail Gonzales, MA, LMHC
• Mariesa Gonzales, DPT, BSHA
• Marissalyn Gonzales
• Marlo Rose Gonzales, NURSE PRACTITIONER
• Martin B. Gonzales, MD
• Mary Gonzales

• Medical Physician Assistant in Albuquerque, NM
• Providers in Albuquerque, 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 Oct 17, 2025; 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.