Individual provider Active NPI

Luis Jesus Carbajal Gonzalez, MD

  • Interventional Cardiology Physician
  • Las Cruces, NM
National Provider Identifier
1417301409
Registry record updated Nov 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
MD2025-1027 Issued in NM
Practice address
2560 Samaritan Dr
Las Cruces, NM 88001-1170
Phone
(575) 800-3868
NPI assigned
Apr 16, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Cardiology Physician 207RI0011X MD2025-1027 NM Primary
Interventional Cardiology Physician 207RI0011X U3811 TX

Addresses

Primary practice location

2560 Samaritan Dr
Las Cruces, NM 88001-1170

Mailing address

4800 Alberta Ave
El Paso, TX 79905-2709

Other practice location 1

4800 Alberta Ave
El Paso, TX 79905-2709
Phone (915) 215-8000

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
I20251205000858 NM Practitioner - Interventional CardiologyPractitioner - Cardiovascular Disease (Cardiology) 8123489994 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Interventional CardiologyAlso: Cardiovascular Disease (Cardiology)
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2550 Samaritan Dr
Las Cruces, NM 88001-1170
Phone (800) 421-8274

2560 Samaritan Dr
Las Cruces, NM 88001-1170
Phone (575) 800-3868

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD2025-1027NMMDInterventional Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Three Crosses Regional Hospital LLC CurrentSince Dec 1, 2025 Accepting new patients
Three Crosses Regional Hospital LLC Past Accepting new patients

Locations

2560 Samaritan Dr
Las Cruces, NM 88001
Phone (575) 800-3868

2560 Samaritan Dr
Ste 121
Las Cruces, NM 88001

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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": "1460764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762905600000",
    "number": "1417301409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4800 ALBERTA AVE",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799052709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2560 SAMARITAN DR",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880011170",
            "telephone_number": "575-800-3868"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4800 Alberta Ave",
            "address_purpose": "LOCATION",
            "city": "El Paso",
            "state": "TX",
            "postal_code": "799052709",
            "country_code": "US",
            "telephone_number": "915-215-8000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARBAJAL GONZALEZ",
        "first_name": "LUIS",
        "middle_name": "JESUS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-16",
        "last_updated": "2025-11-12",
        "certification_date": "2025-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "NM",
            "license": "MD2025-1027",
            "primary": true
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "TX",
            "license": "U3811",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Cruces, NM

Sources for this page

Verify at the official NPI Registry.