Dr Richard Travis Clark, MD | |
2211 Lomas Blvd Ne, Albuquerque, NM 87106-2719 | |
(505) 272-1476 | |
Not Available |
Full Name | Dr Richard Travis Clark |
---|---|
Gender | Male |
Speciality | Diagnostic Radiology |
Experience | 23 Years |
Location | 2211 Lomas Blvd Ne, Albuquerque, New Mexico |
Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1568432557 | NPI | - | NPPES |
0365600 | Other | WA | L&I EVERGREEN RADIA |
0293210 | Other | WA | L&I |
1568432557 | Medicaid | WA | |
0365598 | Other | WA | L&I RADIA-KING COUNTY |
0365595 | Other | WA | L&I RADIA-REST OF WA |
2017034 | Medicaid | WA | |
0365599 | Other | WA | L&I SWEDISH RADIA EDMONDS |
158600 | Other | WA | PTAN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2085R0202X | Radiology - Diagnostic Radiology | MD60212011 (Washington) | Secondary |
2085R0202X | Radiology - Diagnostic Radiology | MD2018-0142 (New Mexico) | Primary |
Facility Name | Location | Facility Type |
---|---|---|
University Of New Mexico Hospital | Albuquerque, NM | Hospital |
Unm Sandoval Regional Medical Center | Rio rancho, NM | Hospital |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
University Of New Mexico Medical Group | 4981795267 | 1002 |
Entity Name | Unm Medical Group Inc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1831218627 PECOS PAC ID: 4981795267 Enrollment ID: O20070801000589 |
Mailing Address | Practice Location Address |
---|---|
Dr Richard Travis Clark, MD 19020 33rd Ave W, Suite 210, Lynnwood, WA 98036-4748 Ph: (425) 563-1500 | Dr Richard Travis Clark, MD 2211 Lomas Blvd Ne, Albuquerque, NM 87106-2719 Ph: (505) 272-1476 |
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. Shaya Ansari, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 8020 Constitution Pl Ne Ste 202, Albuquerque, NM 87110 Phone: 505-998-3096 Fax: 505-998-3100 | |
Dr. Karen Renee Craig, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 2211 Lomas Blvd Ne, Albuquerque, NM 87106 Phone: 505-272-0011 | |
Erika Jane Starks, MD, PHD Radiology Medicare: Medicare Enrolled Practice Location: Radiology Msc 10-5530 1 University Of New Mexico, Albuquerque, NM 87131 Phone: 505-272-6225 | |
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 |