| Miranda C Haley, MD | |
|
117 Camino De Vida, Suite 300, Santa Rosa, NM 88435-2267 | |
| (575) 472-4311 | |
| Not Available |
| Full Name | Miranda C Haley |
|---|---|
| Gender | Female |
| Speciality | Family Practice |
| Experience | 12 Years |
| Location | 117 Camino De Vida, Santa Rosa, New Mexico |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326334814 | NPI | - | NPPES |
| 96507021 | Medicaid | NM |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | MD2014-0107 (New Mexico) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Albuquerque Indian Health Center | 7719883164 | 40 |
| Entity Name | Dhhs Phs Naihs Shiprock Hospital |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1780639971 PECOS PAC ID: 0749193837 Enrollment ID: O20031105000809 |
| Entity Name | Santa Ana Health Center |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1649331323 PECOS PAC ID: 4880590298 Enrollment ID: O20031208000817 |
| Entity Name | Albuquerque Indian Health Center |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1659458917 PECOS PAC ID: 7719883164 Enrollment ID: O20031208001026 |
| Entity Name | Dhhs Phs Naihs Crownpoint Hospital |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1114960093 PECOS PAC ID: 0143128041 Enrollment ID: O20031230000393 |
| Entity Name | Zia Health Center |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1831250398 PECOS PAC ID: 4789652488 Enrollment ID: O20040921000441 |
| Mailing Address | Practice Location Address |
|---|---|
| Miranda C Haley, MD Po Box 26666, Provider Enrollment, Albuquerque, NM 87125-6666 Ph: (505) 923-6770 | Miranda C Haley, MD 117 Camino De Vida, Suite 300, Santa Rosa, NM 88435-2267 Ph: (575) 472-4311 |
Dr. Randal Warren Brown, M.D. Family Medicine Medicare: Medicare Enrolled Practice Location: 117 Camino De Vida, Suite 300, Santa Rosa, NM 88435 Phone: 505-472-4311 Fax: 505-472-4313 | |
Russell Robert Reeves, Family Medicine Medicare: Medicare Enrolled Practice Location: 117 Camino De Vida Ste 300, Santa Rosa, NM 88435 Phone: 575-472-4311 Fax: 877-651-0289 |