Individual provider Active NPI

Wendy Joan Gallegos, M.A. CCC-A

  • Audiologist
  • Corrales, NM
National Provider Identifier
1649379033
Registry record updated Sep 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
NM562 Issued in NM
Practice address
3949 Corrales Rd
Ste 210
Corrales, NM 87048-9347
Phone
(505) 898-2474
Fax
(505) 899-8172
NPI assigned
Sep 21, 2006
Last updated
Sep 29, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 29, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X NM562 NM Primary

Addresses

Primary practice location

3949 Corrales Rd
Ste 210
Corrales, NM 87048-9347

Mailing address

420 Ashley LN
Corrales, NM 87048-8940
Phone (505) 898-2474

Other identifiers 2

IdentifierTypeStateIssuer
K2186MedicaidNM
231H00000XMedicaidNM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120117000060 NM Practitioner - Qualified Audiologist 6002083045 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wendy Gallegos, M.a. LLCGroup PAC ID 5193992139, 3 clinicians

Practice addresses (Care Compare)

3949 Corrales Rd
Suite 210
Corrales, NM 87048-9347
Phone (505) 898-2474

420 Ashley LN
Corrales, NM 87048-8940

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
NM562NMMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Wendy Gallegos, M.a. LLC Audiologist CurrentSince Nov 20, 2011 Accepting new patients

Locations

3949 Corrales Rd
Ste 210
Corrales, NM 87048
Phone (505) 898-2474

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790640000000",
    "number": "1649379033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 ASHLEY LN",
            "city": "CORRALES",
            "state": "NM",
            "postal_code": "870488940",
            "telephone_number": "505-898-2474",
            "fax_number": "505-899-8172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3949 CORRALES RD",
            "address_2": "STE 210",
            "city": "CORRALES",
            "state": "NM",
            "postal_code": "870489347",
            "telephone_number": "505-898-2474",
            "fax_number": "505-899-8172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALLEGOS",
        "first_name": "WENDY",
        "middle_name": "JOAN",
        "credential": "M.A. CCC-A",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-21",
        "last_updated": "2026-09-29",
        "certification_date": "2020-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "NM",
            "license": "NM562",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "K2186",
            "state": "NM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "231H00000X",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Corrales, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.