Bethany Michelle Carvajal, | |
4801 Beckner Rd, Santa Fe, NM 87507-3641 | |
(505) 772-2000 | |
(505) 772-2645 |
Full Name | Bethany Michelle Carvajal |
---|---|
Gender | Female |
Speciality | Pediatrics |
Location | 4801 Beckner Rd, Santa Fe, New Mexico |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1144545997 | NPI | - | NPPES |
47185074 | Medicaid | CO |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208000000X | Pediatrics | MD2018-0652 (New Mexico) | Secondary |
208000000X | Pediatrics | 52395 (Colorado) | Primary |
Entity Name | Presbyterian Healthcare Services |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1104802354 PECOS PAC ID: 9234041708 Enrollment ID: O20031103000603 |
Mailing Address | Practice Location Address |
---|---|
Bethany Michelle Carvajal, 7115 Welford Pl, Castle Pines, CO 80108-3468 Ph: (720) 771-9177 | Bethany Michelle Carvajal, 4801 Beckner Rd, Santa Fe, NM 87507-3641 Ph: (505) 772-2000 |
Dr. Christopher Miles Johnson, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 1850 Bandelier Court, Santa Fe, NM 87505 Phone: 505-795-3208 | |
Daniel Agee Coles, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 1700 Cerrillos Rd, Santa Fe, NM 87505 Phone: 505-988-9821 | |
Wanicha Buraphacheep-coggins, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 2040 S Pacheco St, Nm Doh Family Planning Program, Santa Fe, NM 87505 Phone: 505-476-8870 Fax: 505-476-8898 | |
Dr. Victor Lacerva, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 52 Zambra Way, Santa Fe, NM 87506 Phone: 505-983-4233 | |
Dr. Roberto Thaddeus Araiza, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 2025 Galisteo St, Santa Fe, NM 87505 Phone: 505-995-4901 Fax: 505-989-6426 | |
Comfort Bonu, MD Pediatrics Medicare: Accepting Medicare Assignments Practice Location: 455 Saint Michaels Dr, St. Vincent Hospitalist Group, Santa Fe, NM 87505 Phone: 505-989-6130 Fax: 505-820-5408 |