Jacqueline Acevedo Gonzalez, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

MD2008-0680 Issued in NM

Practice address

1515 West Fir
Portales, NM 88130-0843

Phone

(575) 356-6695

Fax

(575) 356-5948

NPI assigned

Sep 3, 2008

Last updated

Aug 11, 2011By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1220400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1313020800000",
    "number": "1407004583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 843",
            "city": "PORTALES",
            "state": "NM",
            "postal_code": "881300843",
            "telephone_number": "575-356-6695",
            "fax_number": "575-356-5948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 WEST FIR",
            "city": "PORTALES",
            "state": "NM",
            "postal_code": "881300843",
            "telephone_number": "575-356-6695",
            "fax_number": "575-356-5948"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ACEVEDO GONZALEZ",
        "first_name": "JACQUELINE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-03",
        "last_updated": "2011-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NM",
            "license": "MD2008-0680",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "27071383",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kandice Ann Paguio Abaya
• Victoria Jewel Abraham
• Mikaela Ivy-Kian Adais Addams
• Robert Marion Addison, PHC
• Alicia Aguilar
• Taylor Alig
• Mojgan Allamehzadeh

• Internal Medicine Physician in Portales, NM
• Providers in Portales, NM by specialty
• Internal Medicine Physician in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.