| Cibola General Hospital Corporation | |
|
1016 E Roosevelt Ave Grants NM 87020-2118 | |
| (505) 287-5300 | |
| (505) 287-5309 |
| Full Name | Cibola General Hospital Corporation |
|---|---|
| Speciality | General Acute Care Hospital |
| Location | 1016 E Roosevelt Ave, Grants, New Mexico |
| Authorized Official Name and Position | Elizabeth Sellers (CEO) |
| Authorized Official Contact | 5052875300 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Cibola General Hospital Corporation 1016 E Roosevelt Ave Grants NM 87020-2118 Ph: (505) 287-5202 | Cibola General Hospital Corporation 1016 E Roosevelt Ave Grants NM 87020-2118 Ph: (505) 287-5300 |
| NPI Number | 1780677039 |
|---|---|
| Provider Enumeration Date | 08/23/2005 |
| Last Update Date | 04/14/2026 |
| Certification Date | 04/14/2026 |
| Medicare PECOS PAC ID | 7113935891 |
|---|---|
| Medicare Enrollment ID | O20060323000127 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780677039 | NPI | - | NPPES |
| 000729 | Medicaid | NM | |
| 321308 | Other | NM | MEDICARE ID - UNSPECIFIED |
| Provider Name | Stanley R Smith |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1003802968 PECOS PAC ID: 4082527205 Enrollment ID: I20031112000395 |
| Provider Name | Oladipo A Adeniyi |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1497733810 PECOS PAC ID: 5799766630 Enrollment ID: I20040526001641 |
| Provider Name | Loutsios K Ierides |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1578601753 PECOS PAC ID: 8224092705 Enrollment ID: I20041115000794 |
| Provider Name | Michael E Gurule |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1447398623 PECOS PAC ID: 0244215606 Enrollment ID: I20041115000823 |
| Provider Name | Emmanuel L Gallegos |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1740239748 PECOS PAC ID: 1759345853 Enrollment ID: I20041118000217 |
| Provider Name | Victoria Garcia |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1891866331 PECOS PAC ID: 6608827126 Enrollment ID: I20050202000343 |
| Provider Name | Keith G Winterkorn |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1538135165 PECOS PAC ID: 5799732343 Enrollment ID: I20050414001209 |
| Provider Name | Margaret H Chaffey |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1124094792 PECOS PAC ID: 0042257487 Enrollment ID: I20050416000085 |
| Provider Name | Roger L Cronk |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1811963499 PECOS PAC ID: 2860439205 Enrollment ID: I20050416000087 |
| Provider Name | Mark H Depper |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1437125697 PECOS PAC ID: 6305883745 Enrollment ID: I20050416000092 |
| Provider Name | Alexander Lorusso |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1548236102 PECOS PAC ID: 9739154360 Enrollment ID: I20051010000618 |
| Provider Name | Tania D Pence |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1649294125 PECOS PAC ID: 0941203723 Enrollment ID: I20060816000575 |
| Provider Name | Christopher J Creel |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1780763110 PECOS PAC ID: 3577663004 Enrollment ID: I20070712000244 |
| Provider Name | Karen S Sopko |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1063551075 PECOS PAC ID: 8729164199 Enrollment ID: I20080326000010 |
| Provider Name | David Fillmore |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1255315057 PECOS PAC ID: 6901893825 Enrollment ID: I20080501000081 |
| Provider Name | Arnold Valdivia |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1467561118 PECOS PAC ID: 1355412057 Enrollment ID: I20080624000784 |
| Provider Name | Ayodele O Erinle |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1235183492 PECOS PAC ID: 1951313584 Enrollment ID: I20081216000256 |
| Provider Name | Roset D Samuel |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1073590162 PECOS PAC ID: 6406959485 Enrollment ID: I20090330000598 |
| Provider Name | Robert C Orchard |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1659375558 PECOS PAC ID: 8123186178 Enrollment ID: I20100121000295 |
| Provider Name | Mark E Luce |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1285618710 PECOS PAC ID: 1355334483 Enrollment ID: I20100603000862 |
| Provider Name | Roderick D Woods |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1306929633 PECOS PAC ID: 7416846647 Enrollment ID: I20101222001017 |
| Provider Name | Analisa Villarreal |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1952460941 PECOS PAC ID: 4385725258 Enrollment ID: I20110407000019 |
| Provider Name | Mark R Jackson |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1003877077 PECOS PAC ID: 5991740599 Enrollment ID: I20110609000348 |
| Provider Name | Rakesh I Patel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1508069725 PECOS PAC ID: 8224207246 Enrollment ID: I20110809000383 |
| Provider Name | Aleksandr Tsigelnitskiy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518264308 PECOS PAC ID: 9234301722 Enrollment ID: I20111005000306 |
| Provider Name | Dorcas Yates |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003889254 PECOS PAC ID: 6800058918 Enrollment ID: I20120508000284 |
| Provider Name | Brynn J Duerden |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1528232154 PECOS PAC ID: 7618115072 Enrollment ID: I20130718000202 |
| Provider Name | Veronica Y Ruvo |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1740252725 PECOS PAC ID: 4183523855 Enrollment ID: I20140415002165 |
| Provider Name | Walter Mcfarland Bridges |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1851358592 PECOS PAC ID: 5496669889 Enrollment ID: I20150306000620 |
| Provider Name | Brigid Meghan Gerety |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1912950809 PECOS PAC ID: 8729061445 Enrollment ID: I20151117002240 |
| Provider Name | Jimmy C Leung |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1750370714 PECOS PAC ID: 1759370349 Enrollment ID: I20151231001141 |
| Provider Name | Mital Patel |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1891033957 PECOS PAC ID: 7911121793 Enrollment ID: I20160429000636 |
| Provider Name | Charles K Bibby |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1174571517 PECOS PAC ID: 3476544545 Enrollment ID: I20160513000818 |
| Provider Name | Oleh W Hnatiuk |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1811909278 PECOS PAC ID: 4284815507 Enrollment ID: I20160627002375 |
| Provider Name | Ginger A Vaughn |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1558592360 PECOS PAC ID: 3173657848 Enrollment ID: I20160705001509 |
| Provider Name | Shelby Bennett |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1538473491 PECOS PAC ID: 1951603414 Enrollment ID: I20160721000208 |
| Provider Name | Mohammed Quraishi |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1871545269 PECOS PAC ID: 8123030814 Enrollment ID: I20160816002631 |
| Provider Name | Masoud Shiehmorteza |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1164724449 PECOS PAC ID: 3274821376 Enrollment ID: I20161005000740 |
| Provider Name | Michele Idera |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1639154537 PECOS PAC ID: 1254435605 Enrollment ID: I20161017000898 |
| Provider Name | Sara Elizabeth Thorp |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1598031395 PECOS PAC ID: 0648497446 Enrollment ID: I20161121001123 |
| Provider Name | Taylor M Clark |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1336155571 PECOS PAC ID: 5193001014 Enrollment ID: I20170407000863 |
| Provider Name | Sabrina M Lucero-jackson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770039646 PECOS PAC ID: 7012294861 Enrollment ID: I20170503001268 |
| Provider Name | Sean N Covey |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1104861533 PECOS PAC ID: 5799795530 Enrollment ID: I20170516001979 |
| Provider Name | Carolyn Vavrecan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174953947 PECOS PAC ID: 3870719636 Enrollment ID: I20170518002535 |
| Provider Name | Heather Sherwin |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1982016572 PECOS PAC ID: 7214235571 Enrollment ID: I20170728002563 |
| Provider Name | Mark R Walters |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1649301920 PECOS PAC ID: 0446273650 Enrollment ID: I20180320000956 |
| Provider Name | Vanessa Yardley |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1013425800 PECOS PAC ID: 8527320837 Enrollment ID: I20180327001224 |
| Provider Name | Amanda C Young |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1104101757 PECOS PAC ID: 8628350055 Enrollment ID: I20180509000568 |
| Provider Name | Shaya Ansari |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1003851726 PECOS PAC ID: 8527071760 Enrollment ID: I20180807002430 |
| Provider Name | Tiffany Christine Lewis |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1649400870 PECOS PAC ID: 0042336067 Enrollment ID: I20180820000718 |
| Provider Name | Peter E Bergquist |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1982645636 PECOS PAC ID: 6608894928 Enrollment ID: I20181016001225 |
| Provider Name | Stacey Ann Dimitt |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1508151978 PECOS PAC ID: 4486803491 Enrollment ID: I20190226003342 |
| Provider Name | Martin G Fedko |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1134351430 PECOS PAC ID: 4981877594 Enrollment ID: I20190422000593 |
| Provider Name | Zarah Z Ahmed |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1407230857 PECOS PAC ID: 4183958408 Enrollment ID: I20190620000678 |
| Provider Name | Alfredo Nevarez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1558711846 PECOS PAC ID: 4981990686 Enrollment ID: I20190911000091 |
| Provider Name | Perry E Bassett |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1245233857 PECOS PAC ID: 2163325002 Enrollment ID: I20190925001405 |
| Provider Name | Lindsay Andre Worrell |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1689630378 PECOS PAC ID: 2466517016 Enrollment ID: I20191111000973 |
| Provider Name | Joshua Spencer Larson |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1285977736 PECOS PAC ID: 0749569481 Enrollment ID: I20200205001330 |
| Provider Name | James Toshio Ninomiya |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1902858681 PECOS PAC ID: 1850416884 Enrollment ID: I20200513000140 |
| Provider Name | Michael Salisbury |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1497134506 PECOS PAC ID: 4587976295 Enrollment ID: I20200707002041 |
| Provider Name | Martha E Reyes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477043594 PECOS PAC ID: 2769805415 Enrollment ID: I20200714000929 |
| Provider Name | Juliana B Starcevich |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1568880847 PECOS PAC ID: 3375764236 Enrollment ID: I20200716003405 |
| Provider Name | Lauren Noland Mccullough |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1528454949 PECOS PAC ID: 7315251725 Enrollment ID: I20200723000499 |
| Provider Name | Nicole L Pinkerton |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1104895481 PECOS PAC ID: 7113952995 Enrollment ID: I20200731000419 |
| Provider Name | Snow M Petersen |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1487949616 PECOS PAC ID: 2466676572 Enrollment ID: I20200825003395 |
| Provider Name | Tamara Wostal |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093204315 PECOS PAC ID: 4284981085 Enrollment ID: I20201008003578 |
| Provider Name | Ronald W Lavoie |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1962820142 PECOS PAC ID: 2264709203 Enrollment ID: I20201110000754 |
| Provider Name | Erin E Wilkes |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1821282310 PECOS PAC ID: 7113042615 Enrollment ID: I20210202002420 |
| Provider Name | Mrunal P Tailor |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1730573239 PECOS PAC ID: 7618287780 Enrollment ID: I20210505000639 |
| Provider Name | Max Sale |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1447647672 PECOS PAC ID: 4981911658 Enrollment ID: I20210524001043 |
| Provider Name | Joseph Frey |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1528441219 PECOS PAC ID: 2062836844 Enrollment ID: I20210528001595 |
| Provider Name | Niraj Ganjawala |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1346772001 PECOS PAC ID: 1951672690 Enrollment ID: I20210729001298 |
| Provider Name | Manisha V Patel |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1114048493 PECOS PAC ID: 1557467123 Enrollment ID: I20220205000172 |
| Provider Name | Ryan Patrick Starr |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1235659756 PECOS PAC ID: 9739452848 Enrollment ID: I20220210001192 |
| Provider Name | Jason R Ross |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1528300555 PECOS PAC ID: 0648405506 Enrollment ID: I20220307002117 |
| Provider Name | Aaron D Losey |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1326468216 PECOS PAC ID: 3678995123 Enrollment ID: I20220517000796 |
| Provider Name | Stephen Sinclair-hall |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1194386219 PECOS PAC ID: 4688053622 Enrollment ID: I20220621002989 |
| Provider Name | Jason Tyler Dunn |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1194385096 PECOS PAC ID: 5597147017 Enrollment ID: I20220801000657 |
| Provider Name | Cloe Felicya Shelton |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1437298445 PECOS PAC ID: 7911176284 Enrollment ID: I20220815003511 |
| Provider Name | David C Johnson |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1023088531 PECOS PAC ID: 7012991011 Enrollment ID: I20220923000482 |
| Provider Name | Jason Isaac Lindsey |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1154367878 PECOS PAC ID: 8820089733 Enrollment ID: I20220927000575 |
| Provider Name | Gaurav Patel |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1023571379 PECOS PAC ID: 4981089240 Enrollment ID: I20220929001658 |
| Provider Name | Kyle Anderson |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1326383100 PECOS PAC ID: 2668627639 Enrollment ID: I20221013000184 |
| Provider Name | John Joseph Flaherty |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1528143807 PECOS PAC ID: 7315978780 Enrollment ID: I20221227000800 |
| Provider Name | Adelanke Chris-rotimi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205454956 PECOS PAC ID: 7416143078 Enrollment ID: I20230126003296 |
| Provider Name | Monica Omey |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1952393852 PECOS PAC ID: 0941275499 Enrollment ID: I20230216000282 |
| Provider Name | Kaitlin M Peterson |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1669903191 PECOS PAC ID: 6002248564 Enrollment ID: I20230323001970 |
| Provider Name | Sven Eben Rose |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1841257409 PECOS PAC ID: 0042261463 Enrollment ID: I20230410000163 |
| Provider Name | Benjamin A Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205461522 PECOS PAC ID: 0446661466 Enrollment ID: I20230505001623 |
| Provider Name | Elise A Larsen |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1841664380 PECOS PAC ID: 0648638635 Enrollment ID: I20230623000758 |
| Provider Name | Victor K Gutierrez |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1114372059 PECOS PAC ID: 9133413479 Enrollment ID: I20230808000019 |
| Provider Name | Mitra M Campbell |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1013105543 PECOS PAC ID: 8921290719 Enrollment ID: I20231113003619 |
| Provider Name | Patrick J Mcdonnell |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1699836601 PECOS PAC ID: 6800828559 Enrollment ID: I20231115000079 |
| Provider Name | Reyna J Castellano |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1790058022 PECOS PAC ID: 1658729603 Enrollment ID: I20231130003173 |
| Provider Name | Terence J Alost |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1013974724 PECOS PAC ID: 6204816671 Enrollment ID: I20240321000428 |
| Provider Name | Joyce Aiyeojenku |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780295485 PECOS PAC ID: 6608038393 Enrollment ID: I20240325001214 |
| Provider Name | Mark A Stefanelli |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1366486912 PECOS PAC ID: 9830234442 Enrollment ID: I20240326001689 |
| Provider Name | Charity Grant Mcdaniel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003516147 PECOS PAC ID: 1153769831 Enrollment ID: I20240401000259 |
| Provider Name | Linda E Sanders |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1912340191 PECOS PAC ID: 1951681667 Enrollment ID: I20240514002415 |
| Provider Name | Michele M Mccallion-christner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831262401 PECOS PAC ID: 1759775349 Enrollment ID: I20240625003585 |
| Provider Name | Margaret Edmiston |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447727136 PECOS PAC ID: 7618212572 Enrollment ID: I20240706000304 |
| Provider Name | Kevin Hill |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1588244461 PECOS PAC ID: 3476957960 Enrollment ID: I20240709000937 |
| Provider Name | Fazal Khan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1891834685 PECOS PAC ID: 7012065766 Enrollment ID: I20240715001465 |
| Provider Name | Rachael Ann Clark |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1598128290 PECOS PAC ID: 7618415423 Enrollment ID: I20240812002120 |
| Provider Name | Rebecca B Gilson |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1477874014 PECOS PAC ID: 7315187218 Enrollment ID: I20240821001229 |
| Provider Name | Lilian E Ameh |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1497331839 PECOS PAC ID: 7113320292 Enrollment ID: I20240903003261 |
| Provider Name | Huiyuan Jiang |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1891718243 PECOS PAC ID: 0345240891 Enrollment ID: I20241029004331 |
| Provider Name | Chandra Matadeen-ali |
|---|---|
| Provider Type | Practitioner - Sleep Medicine |
| Provider Identifiers | NPI Number: 1811197619 PECOS PAC ID: 8628099090 Enrollment ID: I20250213000881 |
| Provider Name | Evan C Tank |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1124316054 PECOS PAC ID: 9931417813 Enrollment ID: I20250213001806 |
| Provider Name | Kevon M Hekmatdoost |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1144581661 PECOS PAC ID: 3971744806 Enrollment ID: I20250307000539 |
| Provider Name | Fernando J Hernandez |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1811711096 PECOS PAC ID: 7113440405 Enrollment ID: I20250327001413 |
| Provider Name | Chad Herman Barker |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1629336573 PECOS PAC ID: 0244477792 Enrollment ID: I20250410000676 |
| Provider Name | Lindsay B Dlugonski |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124478193 PECOS PAC ID: 7416488960 Enrollment ID: I20250414000070 |
| Provider Name | Matthew Dulles Bourne |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1619437779 PECOS PAC ID: 8325587264 Enrollment ID: I20250415000743 |
| Provider Name | Kimia Khalatbari Kani |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1700028131 PECOS PAC ID: 5991856098 Enrollment ID: I20250415001218 |
| Provider Name | Sean C Chang |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1801108568 PECOS PAC ID: 8325216518 Enrollment ID: I20250415001737 |
| Provider Name | Juan Antonio Lopez |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1801915384 PECOS PAC ID: 9436147766 Enrollment ID: I20250415002275 |
| Provider Name | Sumeet Bahl |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1598104929 PECOS PAC ID: 0941546949 Enrollment ID: I20250415002469 |
| Provider Name | Alfredo William Hurtado |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1881635191 PECOS PAC ID: 5294702106 Enrollment ID: I20250415003087 |
| Provider Name | Oded Greenberg |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1003892928 PECOS PAC ID: 0840341533 Enrollment ID: I20250416001921 |
| Provider Name | Hannah B Wahl |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1013731207 PECOS PAC ID: 7719402247 Enrollment ID: I20250417001093 |
| Provider Name | Muneer J Desai |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1376516021 PECOS PAC ID: 4688645591 Enrollment ID: I20250428003598 |
| Provider Name | Kyle D Hirschman |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1801175401 PECOS PAC ID: 2466686126 Enrollment ID: I20250429001815 |
| Provider Name | Christopher Sidden |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1104872837 PECOS PAC ID: 0840298550 Enrollment ID: I20250430000277 |
| Provider Name | Jake Vrdoljak |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1619976230 PECOS PAC ID: 8527253400 Enrollment ID: I20250502000832 |
| Provider Name | Cedric C W Strange |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1174538730 PECOS PAC ID: 5193760569 Enrollment ID: I20250502001120 |
| Provider Name | Brian Zhu |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1528621828 PECOS PAC ID: 0143765685 Enrollment ID: I20250505000796 |
| Provider Name | Shawn Timothy Stone |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1891040689 PECOS PAC ID: 6103103569 Enrollment ID: I20250505001435 |
| Provider Name | Daniel Alan Keesler |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1205464740 PECOS PAC ID: 5991233306 Enrollment ID: I20250506001051 |
| Provider Name | Hamza Iqbal |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1285299016 PECOS PAC ID: 3971043860 Enrollment ID: I20250506001809 |
| Provider Name | Ron Pearson |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1578901963 PECOS PAC ID: 3971747650 Enrollment ID: I20250507003415 |
| Provider Name | Brandon P Olivieri |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1699064196 PECOS PAC ID: 0042571317 Enrollment ID: I20250508001091 |
| Provider Name | Michael Murphy |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1568435626 PECOS PAC ID: 5092613448 Enrollment ID: I20250508001456 |
| Provider Name | Frank J Welte |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1568676948 PECOS PAC ID: 6800933847 Enrollment ID: I20250512001910 |
| Provider Name | Shannon L St Clair |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1881030997 PECOS PAC ID: 3678714268 Enrollment ID: I20250519000396 |
| Provider Name | Karen Phillips |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1801992813 PECOS PAC ID: 8729024161 Enrollment ID: I20250520001991 |
| Provider Name | Filip Turcer |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1922366657 PECOS PAC ID: 9931345451 Enrollment ID: I20250527000124 |
| Provider Name | Bryan Suchecki |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1184686933 PECOS PAC ID: 7416119540 Enrollment ID: I20250603002630 |
| Provider Name | Yuyang Zhang |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1538304035 PECOS PAC ID: 4880833615 Enrollment ID: I20250604002874 |
Presbyterian Medical Services Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 833 E Roosevelt Ave, Grants, NM 87020 Phone: 505-287-2958 Fax: 505-287-2403 | |
Fenton Family Medical Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 765 E Roosevelt Ave, Grants, NM 87020 Phone: 505-685-1347 | |
Beverly Michael Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1109 Mesa Blvd, Suite D, Grants, NM 87020 Phone: 505-287-3773 Fax: 505-287-5115 | |
Soft Nations, Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 824 Mount Taylor Ave, Grants, NM 87020 Phone: 505-610-5897 | |
Tribeaid Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 824 Mount Taylor Ave, Grants, NM 87020 Phone: 505-610-5897 | |
Bethphage Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 920 Lobo Canyon Rd, Suite 5a, Grants, NM 87020 Phone: 505-287-9333 Fax: 505-287-9336 | |
Winds Of Change Mental Health Services, Llc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 200 N 1st St Ste B, Grants, NM 87020 Phone: 505-290-4551 Fax: 505-658-2398 |