Individual provider Active NPI

Frank V. Gallegos Jr., M.D.

  • Family Medicine Physician
  • Las Vegas, NM
National Provider Identifier
1619960069
Registry record updated Apr 9, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
90-42 Issued in NM
Practice address
3031 Hot Springs Blvd
Las Vegas, NM 87701-4120
Phone
(505) 425-6788
Fax
(505) 425-5408
NPI assigned
Aug 31, 2005
Last updated
Apr 9, 2010By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 9, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 90-42 NM Primary

Addresses

Primary practice location

3031 Hot Springs Blvd
Las Vegas, NM 87701-4120

Mailing address

1900 Hot Springs Blvd Ste D
Las Vegas, NM 87701-3480
Phone (505) 425-3718

Other identifiers 1

IdentifierTypeStateIssuer
25551MedicaidNM

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
I20070724000260 NM Practitioner - Family Practice 6901907708 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Iowa, RJ & L Carver College of Medicine, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
El Centro Family HealthGroup PAC ID 9830080688, 31 clinicians

Practice addresses (Care Compare)

1235 8TH St
Las Vegas, NM 87701-4219
Phone (505) 425-6788

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
90-42NMMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
El Centro Family Health CurrentSince Jan 22, 2024 Accepting new patients
El Centro Family Health CurrentSince Jan 22, 2024 Accepting new patients
San Miguel Clinic Corp Family Medicine Past Accepting new patients
El Centro Family Health Past Accepting new patients

Locations

111 N Railroad Ave
Espanola, NM 87532
Phone (505) 587-2809

538 N Paseo de Onate
Espanola, NM 87532
Phone (505) 753-7218

1235 8th St
Las Vegas, NM 87701
Phone (505) 425-6751

Organizations & group practices 4

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 3

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": "1125446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1270771200000",
    "number": "1619960069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 HOT SPRINGS BLVD STE D",
            "city": "LAS VEGAS",
            "state": "NM",
            "postal_code": "877013480",
            "telephone_number": "505-425-3718",
            "fax_number": "505-425-3748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3031 HOT SPRINGS BLVD",
            "city": "LAS VEGAS",
            "state": "NM",
            "postal_code": "877014120",
            "telephone_number": "505-425-6788",
            "fax_number": "505-425-5408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALLEGOS",
        "first_name": "FRANK",
        "middle_name": "V.",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-31",
        "last_updated": "2010-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NM",
            "license": "90-42",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "25551",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NM

Sources for this page

Verify at the official NPI Registry.