Ivyrose Gonzales, MOTR/L,ATC

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

0805 Issued in NM

Practice address

2727 San Pedro Dr NE
Ste 116
Albuquerque, NM 87110-3364

Phone

(505) 350-3069

Fax

(505) 508-2305

NPI assigned

Aug 20, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NM

Enrollment records 1

Specialty

Occupational Therapist in Private Practice

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Janelle Jackson, PT,DPT

  • Physical Therapist
  • Albuquerque, NM
  • NPI 1497155816
  Medicare reassignment

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.

• Independent Living Therapy Services, LLC

  • Occupational Therapist
  • Albuquerque, NM
  • NPI 1710296496
  NPD Authorized official

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

{
    "created_epoch": "1219190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552521600000",
    "number": "1750538807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12105 DAN PATCH RD SE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871232196",
            "telephone_number": "505-350-3069",
            "fax_number": "505-508-2305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2727 SAN PEDRO DR NE",
            "address_2": "STE 116",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871103364",
            "telephone_number": "505-350-3069",
            "fax_number": "505-508-2305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALES",
        "first_name": "IVYROSE",
        "name_prefix": "Ms.",
        "credential": "MOTR/L,ATC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-08-20",
        "last_updated": "2019-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NM",
            "license": "0805",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "93985312",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gabrielle Gonzales
• Hannah Gonzales
• Helen Gonzales
• Isabel Gonzales, PTA
• Ivory Gonzales
• Jacqueline Gonzales
• James O Gonzales, MD
• Jamielynn Gonzales, DSW, LCSW, FSW
• Janelle Gonzales
• Janis Gonzales, MD

• Occupational Therapist in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Occupational Therapist in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2019; 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.