Individual provider Active NPI

Luis Fernando Gonzalez Mosquera, M.D.

  • Hematology & Oncology Physician
  • Roswell, NM
National Provider Identifier
1902395601
Registry record updated Jun 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
MD2025-0074 Issued in NM
Practice address
400 Military Heights PL
Roswell, NM 88201-6407
Phone
(575) 627-9110
Fax
(575) 627-9535
NPI assigned
May 8, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Student in an Organized Health Care Education/Training Program 390200000X 4351048906 MI
Hematology & Oncology Physician 207RH0003X MD2025-0074 NM Primary

Addresses

Primary practice location

400 Military Heights PL
Roswell, NM 88201-6407

Mailing address

2800 W Grand Blvd
Detroit, MI 48202-2610
Phone (888) 777-4167

Other practice location 1

2800 W Grand Blvd
Detroit, MI 48202-2610
Phone (888) 777-4167

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
I20250611001041 NM Practitioner - Hematology/Oncology 3870832538 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hematology/Oncology
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Masoud Khorsand- Sahbaie MD P aGroup PAC ID 8729068911, 19 clinicians

Practice addresses (Care Compare)

400 Military Heights PL
Roswell, NM 88201-6407
Phone (575) 627-9500

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4351048906MIMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Masoud Khorsand- Sahbaie MD P a Hematology & Oncology CurrentSince Jul 2, 2025 Accepting new patients
Masoud Khorsand-Sahbaie, MD PA CurrentSince Jul 2, 2025 Accepting new patients

Locations

101 S Canal St
Carlsbad, NM 88220
Phone (575) 234-0500

3028 N Grimes St
Hobbs, NM 88240
Phone (575) 392-0222

407 W Country Club Rd
Roswell, NM 88201
Phone (505) 627-9110

400 Military Heights Pl
Roswell, NM 88201
Phone (575) 627-9110

Interoperability endpoints

  • Direct secure messaging: lgonzalezmosquera778236@direct.hfhs.org
  • Direct secure messaging: luis.gonzalezmosquera.p1@direct.kymeramedical.nextgenshare.com

Organizations & group practices 2

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 5

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": "1525737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750291200000",
    "number": "1902395601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2800 W GRAND BLVD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482022610",
            "telephone_number": "888-777-4167",
            "fax_number": "313-916-4989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 MILITARY HEIGHTS PL",
            "city": "ROSWELL",
            "state": "NM",
            "postal_code": "882016407",
            "telephone_number": "575-627-9110",
            "fax_number": "575-627-9535"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2800 W Grand Blvd",
            "address_purpose": "LOCATION",
            "city": "Detroit",
            "state": "MI",
            "postal_code": "482022610",
            "country_code": "US",
            "telephone_number": "888-777-4167",
            "fax_number": "313-916-4989",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GONZALEZ MOSQUERA",
        "first_name": "LUIS",
        "middle_name": "FERNANDO",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-05-08",
        "last_updated": "2025-06-19",
        "certification_date": "2025-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MI",
            "license": "4351048906",
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "NM",
            "license": "MD2025-0074",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roswell, NM

Sources for this page

Verify at the official NPI Registry.