NPIMap

Individual provider Active NPI

Jaime Gonzalez, M.D.

  • Internal Medicine Physician
  • El Paso, TX
National Provider Identifier
1477848695
Registry record updated Jun 15, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
BP10040409 Issued in TX
Practice address
4800 Alberta Ave
El Paso, TX 79905-2709
Phone
(915) 545-6616
NPI assigned
Jun 15, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 15, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X BP10040409 TX Primary

Addresses

Primary practice location

4800 Alberta Ave
El Paso, TX 79905-2709

Mailing address

574 River Valley St
El Paso, TX 79915-4829
Phone (915) 539-8286

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20151124000535 TX Practitioner - NephrologyPractitioner - Internal Medicine 8123346764 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
El Paso Kidney Specialists PAGroup PAC ID 6608866819, 9 clinicians

Practice addresses (Care Compare)

11989 Pellicano Dr
Suite C
El Paso, TX 79936-6288
Phone (915) 857-0700

1601 Brown St
El Paso, TX 79902-4724
Phone (915) 544-4500

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
BP10040409TXMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
El Paso Kidney Specialists PA CurrentSince Nov 1, 2017 Accepting new patients
El Paso County Hospital District Past Accepting new patients

Locations

11989 Pellicano Dr
Ste C
El Paso, TX 79936
Phone (915) 857-0700

1601 Brown St
El Paso, TX 79902
Phone (915) 533-1789

Interoperability endpoints

  • Direct secure messaging: jaime.gonzalez1@direct.myhealthep.org
  • FHIR API: https://api.platform.athenahealth.com/17767/brand/1/csg/1/fhir/r4
  • Direct secure messaging: jaime.gonzalez.1@17767.direct.athenahealth.com

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 and National Provider Directory roles.

Hospital & facility affiliations 9

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": "1308096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1308096000000",
    "number": "1477848695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "574 RIVER VALLEY ST",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799154829",
            "telephone_number": "915-539-8286"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4800 ALBERTA AVE",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799052709",
            "telephone_number": "915-545-6616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "JAIME",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-06-15",
        "last_updated": "2011-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "BP10040409",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in El Paso, TX

Sources for this page

Verify at the official NPI Registry.