NPIMap

Individual provider Active NPI

Miguel A Gonzalez, MD

  • Internal Medicine Physician
  • Las Vegas, NV
National Provider Identifier
1376525352
Registry record updated Feb 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
9622 Issued in NV
Practice address
9030 W Sahara Ave # 260
Las Vegas, NV 89117-5744
Phone
(702) 321-5293
Fax
(702) 463-1507
NPI assigned
Nov 16, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X 9622 NV
Internal Medicine Physician 207R00000X 9622 NV Primary

Addresses

Primary practice location

9030 W Sahara Ave # 260
Las Vegas, NV 89117-5744

Mailing address

9030 W Sahara Ave # 260
Las Vegas, NV 89117-5744
Phone (702) 321-5293

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040429000317 NV Practitioner - Internal Medicine 9335136555 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2075 E Flamingo Rd
Desert Springs Hospital
Las Vegas, NV 89119-5188
Phone (702) 733-8800

3001 Saint Rose Pkwy
Henderson, NV 89052-3839
Phone (702) 616-5000

8280 W Warm Springs Rd
Las Vegas, NV 89113-3612
Phone (702) 616-5000

Hospital & facility affiliations

  • Reverent Hospice Care Inc Hospice, Henderson, NV, CCN 291682
  • Boulder City Hospital Hospital, Boulder City, NV, CCN 291309
  • Saint Rose Dominican Hospitals - Siena Campus Hospital, Henderson, NV, CCN 290045
  • Saint Rose Dominican Hospitals - San Martin Campus Hospital, Las Vegas, NV, CCN 290053
  • Advanced Health Care of Henderson Nursing home, Las Vegas, NV, CCN 295102
  • Boulder City Hospital Nursing home, CCN 29Z309

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9622NVMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Miguel Gonzales M D Prof Corp Internal Medicine CurrentSince Feb 19, 2004 Accepting new patients
Craig M Jorgenson MD LTD Internal Medicine Past Accepting new patients
Boulder City Hospital Inc Past Accepting new patients

Locations

2075 E Flamingo Rd
Las Vegas, NV 89119
Phone (702) 369-7613

9030 W Sahara Ave
Las Vegas, NV 89117
Phone (702) 256-8686

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Advanced Health Care of HendersonLas Vegas, NV, CCN 295102 Skilled nursing facility Contracted Managing Employee Jan 1, 2024

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 3

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 6

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": "1132099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549670400000",
    "number": "1376525352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9030 W SAHARA AVE # 260",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891175744",
            "telephone_number": "702-321-5293",
            "fax_number": "702-463-1507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9030 W SAHARA AVE # 260",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891175744",
            "telephone_number": "702-321-5293",
            "fax_number": "702-463-1507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "MIGUEL",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-16",
        "last_updated": "2019-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "NV",
            "license": "9622",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NV",
            "license": "9622",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.