| Dr Juan Carlos Mena, MD | |
| 
					4411 The 25 Way Ne, Suite 150, Albuquerque, NM 87109-5857  | |
| (505) 332-6900 | |
| (505) 332-6921 | 
| Full Name | Dr Juan Carlos Mena | 
|---|---|
| Gender | Male | 
| Speciality | Radiology - Diagnostic Radiology | 
| Location | 4411 The 25 Way Ne, Albuquerque, 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 | 
|---|---|---|---|
| 1184696387 | NPI | - | NPPES | 
| 600521002 | Other | NM | MEDICARE IDTF | 
| 800521226 | Other | NM | MEDICARE IDTF | 
| 2258272 | Other | NM | MEDICARE GROUP | 
| 700521102 | Other | NM | MEDICARE GROUP | 
| 45138 | Medicaid | NM | |
| 52713 | Medicaid | NM | |
| 68071019 | Medicaid | NM | |
| 1492060 | Medicaid | LA | |
| L0634 | Medicaid | NM | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 2085R0202X | Radiology - Diagnostic Radiology | 20050716 (New Mexico) | Primary | 
| Entity Name | Radiology Associates Of Albuquerque Pa | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1881666998 PECOS PAC ID: 2860304482 Enrollment ID: O20031103000381  | 
| Entity Name | Sierra Vista Hospital 69 | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1760446009 PECOS PAC ID: 0143122416 Enrollment ID: O20040126000840  | 
| Mailing Address | Practice Location Address | 
|---|---|
| Dr Juan Carlos Mena, MD 4411 The 25 Way Ne, Suite 150, Albuquerque, NM 87109-5857 Ph: (505) 332-6900  | Dr Juan Carlos Mena, MD 4411 The 25 Way Ne, Suite 150, Albuquerque, NM 87109-5857 Ph: (505) 332-6900  | 
Mark Ehrhart, MD Radiology Medicare: Medicare Enrolled Practice Location: Msc 10 5550, 1 University Of New Mexico, Albuquerque, NM 87131 Phone: 505-272-4661  | |
Dr. Karen Renee Craig, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 2211 Lomas Blvd Ne, Albuquerque, NM 87106 Phone: 505-272-0011  | |
Stuart Bernard Paster,  Radiology Medicare: Not Enrolled in Medicare Practice Location: 8020 Constitution Place Ne, #101, Albuquerque, NM 87110 Phone: 505-998-1317 Fax: 505-998-1308  | |
Danielle Eckart Sorte, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: Dept Of Radiology Msc 10 5530, 1 University Of New Mexico, Albuquerque, NM 87131 Phone: 801-641-5515  | |
Dr. Luis Centenera, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 4411 The 25 Way Ne, Suite 150, Albuquerque, NM 87109 Phone: 505-332-5800 Fax: 505-332-6919  | |
Ryan Craig Lebaron, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: Msc10 5530, 1 University Of New Mexico, Albuquerque, NM 87131 Phone: 505-272-6225  | |
Glenn S. Roush, M.D. Radiology Medicare: Not Enrolled in Medicare Practice Location: 4411 The 25 Way Ne, Albuquerque, NM 87109 Phone: 505-332-6921 Fax: 256-382-6455  |