Individual provider Active NPI

Hannah Gonzales

  • Speech-Language Pathologist
  • Albuquerque, NM
National Provider Identifier
1497892715
Registry record updated Oct 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SLP7173 Issued in NM
Practice address
415 Cedar St SE
Albuquerque, NM 87106-3927
Phone
(505) 224-7023
NPI assigned
Jan 30, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X SLP4723 AZ
Speech-Language Pathologist 235Z00000X SLP7173 NM Primary

Addresses

Primary practice location

415 Cedar St SE
Albuquerque, NM 87106-3927

Mailing address

11724 Tivoli Ave NE
Albuquerque, NM 87111-5241
Phone (602) 541-0981

Other practice location 1

661 Quantum Rd NE
Rio Rancho, NM 87124-4505
Phone (602) 541-0981

Other identifiers 1

IdentifierTypeStateIssuer
125477MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SLP4723AZMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Presbyterian Ear Institute Speech-Language Pathologist CurrentSince Dec 30, 2024 Accepting new patients
Advanced Therapy Solutions, LLC PastSince Dec 1, 2015 Accepting new patients
Mentis Reo, LLC. PastSince Aug 28, 2021 Accepting new patients

Locations

415 Cedar St SE
Albuquerque, NM 87106
Phone (505) 224-7020

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.

NPI Registry JSON

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696464000000",
    "number": "1497892715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11724 TIVOLI AVE NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871115241",
            "telephone_number": "602-541-0981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 CEDAR ST SE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871063927",
            "telephone_number": "505-224-7023"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "661 Quantum Rd NE",
            "address_purpose": "LOCATION",
            "city": "Rio Rancho",
            "state": "NM",
            "postal_code": "871244505",
            "country_code": "US",
            "telephone_number": "602-541-0981",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GONZALES",
        "first_name": "HANNAH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-30",
        "last_updated": "2023-10-05",
        "certification_date": "2023-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "AZ",
            "license": "SLP4723",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NM",
            "license": "SLP7173",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "125477",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2023; 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.