NPIMap

Individual provider Active NPI

Gaudencio Ortiz Pavia, M.D.

  • Internal Medicine Physician
  • Las Cruces, NM
National Provider Identifier
1881760957
Registry record updated Jun 24, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD2003-0735 Issued in NM
Practice address
1180 Mall Dr
#A
Las Cruces, NM 88011-8101
Phone
(505) 523-4344
Fax
(505) 647-8381
NPI assigned
Nov 28, 2006
Last updated
Jun 24, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD2003-0735 NM Primary

Addresses

Primary practice location

1180 Mall Dr
#A
Las Cruces, NM 88011-8101

Mailing address

PO Box 1560
Las Cruces, NM 88004-1560
Phone (575) 647-8366

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040309001048 NM Practitioner - Internal Medicine 8729976865 Reassigns benefits to 1 organization
Practice locations: Las Cruces, NM

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1180 Mall Dr
Suite a
Las Cruces, NM 88011-8192
Phone (575) 523-4344

4351 E Lohman Ave
Suite 200
Las Cruces, NM 88011-8260
Phone (505) 532-9755

4351 E Lohman Ave
Suite 403
Las Cruces, NM 88011-8261
Phone (575) 522-6806

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD2003-0735NMMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Las Cruces Physician Practices, LLC Current Accepting new patients
Las Cruces Physician Practices, LLC CurrentSince Jan 1, 2019 Accepting new patients
Las Cruces Physician Practices, LLC CurrentSince Jan 1, 2019 Accepting new patients
Las Cruces Physician Practices, LLC Internal Medicine Past Accepting new patients
Gaudencio Pavia MD LLC Internal Medicine Past Accepting new patients

Locations

1180 Mall Dr
Ste A
Las Cruces, NM 88011
Phone (505) 523-4344

150 N Roadrunner Pkwy
Las Cruces, NM 88011
Phone (505) 521-5900

2450 S Telshor Blvd
Las Cruces, NM 88011
Phone (505) 522-8641

4351 E Lohman Ave
Ste 200
Las Cruces, NM 88011
Phone (505) 532-9755

4351 E Lohman Ave
Ste 403
Las Cruces, NM 88011
Phone (575) 522-6806

Interoperability endpoints

  • Direct secure messaging: gaudencio.pavia.1@19849.direct.athenahealth.com

Organizations & group practices 5

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 10

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": "1164672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214265600000",
    "number": "1881760957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1560",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880041560",
            "telephone_number": "575-647-8366",
            "fax_number": "575-647-8381"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1180 MALL DR",
            "address_2": "#A",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880118101",
            "telephone_number": "505-523-4344",
            "fax_number": "505-647-8381"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAVIA",
        "first_name": "GAUDENCIO",
        "middle_name": "ORTIZ",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-28",
        "last_updated": "2008-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NM",
            "license": "MD2003-0735",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Cruces, NM

Sources for this page

Verify at the official NPI Registry.