Gabriel Botelho Bastos Zaverucha, MD
Individual provider Active NPI Internal Medicine Physician · Espanola, NM
NPI 1669257697 · NPPES record last updated Aug 21, 2026
Key facts
- NPI
- 1669257697
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- MD2026-0160 (NM)
- Practice address
- 1010 Spruce St
Espanola, NM 87532-2746 - Phone
- (505) 367-0343
- Fax
- (505) 367-4470
- NPI assigned
- Aug 28, 2023
- Sex
- Male
- Sole proprietor
- No
Medicare Care Compare profile
- Specialty
- Internal Medicine
- Education
- Other, 2018
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
321 S Broad St
Elizabeth, NJ 07202-3695
PO Box
Albuquerque, NM 87125
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NM
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20260611002638 | NM | Practitioner - Internal Medicine | 6002388923 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | MD2026-0160 | NM | Yes |
Addresses
Primary practice location
1010 Spruce St
Espanola, NM 87532-2746
Mailing address
1010 Spruce St
Espanola, NM 87532-2746
Phone (505) 367-0343
Other providers in Espanola, NM
- Salim Bohsali
- Erin Boldt
- Mark Douglas Bonnell
- Angela Borrego
- Ashley Borrego
- Mireya Bouquin
- Amy A Bowen
- Marian Clair Bradbury
- Katlyn Maegan Brantley
- Breath of My Heart
All providers in Espanola, NM · Internal Medicine Physician in New Mexico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 21, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.