AUTUMN MARIE GONZALES NPI 1073275756

NPI Information

  • NPI: 1073275756
  • Provider Name: AUTUMN MARIE GONZALES
  • Classification: Physician Assistant - 363AM0700X
  • Specialization: Medical
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 3917 WEST RD STE A
    LOS ALAMOS, NM
    ZIP 87544
  • Phone: (505) 661-8900

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NPI Details

Autumn Marie Gonzales is a medical physician assistant in Los Alamos, NM with 2 years of experience. Autumn Marie Gonzales NPI is 1073275756. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

3917 WEST RD STE A
LOS ALAMOS, NM
ZIP 87544-292
Phone: (505) 661-8900

The NPI 1073275756 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 10/9/2021 and was last updated on 8/9/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1390200000XStudent in an Organized Health Care Education/Training ProgramNo
2363AM0700XPhysician AssistantMedicalPA2023-0240NEW MEXICOYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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