| Albuquerque Indian Health Center | |
|
801 Vassar Dr Ne Albuquerque NM 87106-2725 | |
| (505) 248-4062 | |
| (505) 248-4093 |
| Full Name | Albuquerque Indian Health Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 801 Vassar Dr Ne, Albuquerque, New Mexico |
| Authorized Official Name and Position | Jacqueline E Alexander (CEO, ACTING) |
| Authorized Official Contact | 5052484062 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Albuquerque Indian Health Center 801 Vassar Drive Ne Albuquerque NM 87106 Ph: (505) 248-4052 | Albuquerque Indian Health Center 801 Vassar Dr Ne Albuquerque NM 87106-2725 Ph: (505) 248-4062 |
| NPI Number | 1659458917 |
|---|---|
| Provider Enumeration Date | 11/01/2006 |
| Last Update Date | 03/25/2013 |
| Medicare PECOS PAC ID | 7719883164 |
|---|---|
| Medicare Enrollment ID | O20031208001026 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659458917 | NPI | - | NPPES |
| H7890 | Medicaid | NM |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Kerry A Hile |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1972683878 PECOS PAC ID: 6800796558 Enrollment ID: I20040109001052 |
| Provider Name | Lydia Alvarez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407833239 PECOS PAC ID: 9537133137 Enrollment ID: I20040820000183 |
| Provider Name | Ralph J Groves |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1679652218 PECOS PAC ID: 3476527078 Enrollment ID: I20040820000232 |
| Provider Name | Anthony P Stout |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1306816343 PECOS PAC ID: 2264499946 Enrollment ID: I20041214000804 |
| Provider Name | Timothy T Mccay |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1245221761 PECOS PAC ID: 2961456538 Enrollment ID: I20050621000935 |
| Provider Name | Dean Roy Fullingim |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1770574253 PECOS PAC ID: 5193710929 Enrollment ID: I20050712000568 |
| Provider Name | Sheila Malone Taber |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1447241971 PECOS PAC ID: 1557311495 Enrollment ID: I20050715000344 |
| Provider Name | George E Erbacher |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1326039801 PECOS PAC ID: 5991755829 Enrollment ID: I20050720000214 |
| Provider Name | Felino A Pascual |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1801877055 PECOS PAC ID: 6002801834 Enrollment ID: I20050728000628 |
| Provider Name | John S Dennis |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1871584060 PECOS PAC ID: 3173594389 Enrollment ID: I20050728000739 |
| Provider Name | Miranda H Durham |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1548326515 PECOS PAC ID: 1153350897 Enrollment ID: I20050811001056 |
| Provider Name | Massi H Wyatt |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1578655460 PECOS PAC ID: 2769479096 Enrollment ID: I20051017000726 |
| Provider Name | John D Walton |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1326096850 PECOS PAC ID: 3375546054 Enrollment ID: I20060907000113 |
| Provider Name | Myeong S Yoon |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1497722342 PECOS PAC ID: 0042227266 Enrollment ID: I20070219000272 |
| Provider Name | Joel A Di Santi |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1124099478 PECOS PAC ID: 4688771512 Enrollment ID: I20070529000463 |
| Provider Name | Kate C Faber |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902883044 PECOS PAC ID: 3375594773 Enrollment ID: I20070718000791 |
| Provider Name | Christopher C Cordes |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1033318902 PECOS PAC ID: 7517053085 Enrollment ID: I20071013000012 |
| Provider Name | Martin J Kileen |
|---|---|
| Provider Type | Practitioner - Preventive Medicine |
| Provider Identifiers | NPI Number: 1770789125 PECOS PAC ID: 1850470576 Enrollment ID: I20080507000167 |
| Provider Name | Donald W Clark |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1083773931 PECOS PAC ID: 4688749336 Enrollment ID: I20080815000087 |
| Provider Name | Judith Wolfstein |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1013914456 PECOS PAC ID: 0345135232 Enrollment ID: I20081203000298 |
| Provider Name | Nicole S Emil |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1437298452 PECOS PAC ID: 9234216201 Enrollment ID: I20090303000513 |
| Provider Name | Jason Pack |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1861549743 PECOS PAC ID: 3375623887 Enrollment ID: I20090305000362 |
| Provider Name | Ralph Noah |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1669458741 PECOS PAC ID: 6800966284 Enrollment ID: I20090326000463 |
| Provider Name | Hooby P Yoon |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1508066473 PECOS PAC ID: 4486705779 Enrollment ID: I20090626000135 |
| Provider Name | Kelly Cole |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1699958157 PECOS PAC ID: 0648322024 Enrollment ID: I20090916000496 |
| Provider Name | Jeremy Scott Fullingim |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1255537304 PECOS PAC ID: 5092867762 Enrollment ID: I20090917000124 |
| Provider Name | Damon L Brooks |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1558583963 PECOS PAC ID: 4587715354 Enrollment ID: I20090917000269 |
| Provider Name | Robert S Chang |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1144351586 PECOS PAC ID: 5991768145 Enrollment ID: I20100302000742 |
| Provider Name | Michelle M Ponder |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1447399415 PECOS PAC ID: 4880787217 Enrollment ID: I20100428000166 |
| Provider Name | Christos Vassiliou |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1053567784 PECOS PAC ID: 8820120454 Enrollment ID: I20100719000117 |
| Provider Name | Rose Rowan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942445101 PECOS PAC ID: 0749479020 Enrollment ID: I20110118001316 |
| Provider Name | Daniel J Langsam |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1063679652 PECOS PAC ID: 4587843586 Enrollment ID: I20110124000362 |
| Provider Name | Mark S Simpson |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1518952662 PECOS PAC ID: 6709901044 Enrollment ID: I20110217000827 |
| Provider Name | Lynn A Abeita |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1194826768 PECOS PAC ID: 0547443467 Enrollment ID: I20110330000160 |
| Provider Name | Nina C Jones |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1003877754 PECOS PAC ID: 6901833367 Enrollment ID: I20110414000371 |
| Provider Name | Stephen A Back |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1639302060 PECOS PAC ID: 3476723594 Enrollment ID: I20110829000547 |
| Provider Name | Anthony N Fleg |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1538333554 PECOS PAC ID: 3375717259 Enrollment ID: I20111111000452 |
| Provider Name | Erica M Lindsey |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1265660989 PECOS PAC ID: 4587820352 Enrollment ID: I20120723000776 |
| Provider Name | Patrick B O Hayre |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1518134352 PECOS PAC ID: 2264695402 Enrollment ID: I20120730000568 |
| Provider Name | Leila Danielle See |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1013164268 PECOS PAC ID: 6800059064 Enrollment ID: I20120810000291 |
| Provider Name | Jeffrey W Shelton |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1194864074 PECOS PAC ID: 7719141639 Enrollment ID: I20120823000396 |
| Provider Name | Jonathon D Kirkland |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1639315260 PECOS PAC ID: 4789823139 Enrollment ID: I20130726000027 |
| Provider Name | Robert J Surawski |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1417277732 PECOS PAC ID: 2668613613 Enrollment ID: I20130802000381 |
| Provider Name | James N Pham |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1306089578 PECOS PAC ID: 4284876558 Enrollment ID: I20130911000061 |
| Provider Name | Todd A Powell |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1821375361 PECOS PAC ID: 3971777020 Enrollment ID: I20131017001423 |
| Provider Name | Kerri Leslie Kremer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265403588 PECOS PAC ID: 2264591593 Enrollment ID: I20140214001179 |
| Provider Name | Brooke White |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1558679035 PECOS PAC ID: 4688807464 Enrollment ID: I20140516000548 |
| Provider Name | Cheryle E Bakewell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679770283 PECOS PAC ID: 9931347986 Enrollment ID: I20140717000561 |
| Provider Name | Miranda C Haley |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1326334814 PECOS PAC ID: 8527202217 Enrollment ID: I20140717001234 |
| Provider Name | Travis J Townsend |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1568787554 PECOS PAC ID: 0547487092 Enrollment ID: I20140807001039 |
| Provider Name | Nicholas Bull |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1487968756 PECOS PAC ID: 6507099389 Enrollment ID: I20140821001827 |
| Provider Name | Peter J Mostert |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1326346875 PECOS PAC ID: 2860635844 Enrollment ID: I20140828001578 |
| Provider Name | Anthony Morton |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1922018217 PECOS PAC ID: 6608094560 Enrollment ID: I20140906000056 |
| Provider Name | Bo Yon Choi |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1053551721 PECOS PAC ID: 5890920870 Enrollment ID: I20140925002205 |
| Provider Name | Kathy M Jackson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1215971379 PECOS PAC ID: 2365446127 Enrollment ID: I20141224000362 |
| Provider Name | David J Ingle |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1700884491 PECOS PAC ID: 4688561368 Enrollment ID: I20150116001899 |
| Provider Name | William H Shunkamolah |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1578862504 PECOS PAC ID: 6709101876 Enrollment ID: I20150212000366 |
| Provider Name | Marcia Oliver |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1396722849 PECOS PAC ID: 1254592892 Enrollment ID: I20150415001022 |
| Provider Name | Janet M Thurston |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235211962 PECOS PAC ID: 8628126091 Enrollment ID: I20150430000583 |
| Provider Name | Jamie Christine Gomez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1083708457 PECOS PAC ID: 5890836472 Enrollment ID: I20150602001452 |
| Provider Name | Kyle G Flowers |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1063710580 PECOS PAC ID: 2769703107 Enrollment ID: I20150610001387 |
| Provider Name | Tanakorn Songrug |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1073847455 PECOS PAC ID: 7416184478 Enrollment ID: I20150615002064 |
| Provider Name | Donald Von Borstel |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1275887663 PECOS PAC ID: 3779894860 Enrollment ID: I20150617001059 |
| Provider Name | Marcus Brown |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1275776965 PECOS PAC ID: 8224250816 Enrollment ID: I20150910000185 |
| Provider Name | Amy Crowder |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1831164342 PECOS PAC ID: 3072590249 Enrollment ID: I20160108000090 |
| Provider Name | George Polanco |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1326019332 PECOS PAC ID: 0244210755 Enrollment ID: I20160713002114 |
| Provider Name | Ronald A Stillerman |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1679549166 PECOS PAC ID: 7214958370 Enrollment ID: I20161122000168 |
| Provider Name | Bart M Rowlett |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1104945526 PECOS PAC ID: 5092602102 Enrollment ID: I20170215002368 |
| Provider Name | Emad Hamid |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1457553588 PECOS PAC ID: 7618021999 Enrollment ID: I20170502001404 |
| Provider Name | Kenneth E Mann |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1851398713 PECOS PAC ID: 7113985441 Enrollment ID: I20170519000382 |
| Provider Name | Blake Edward Weaver |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1497785893 PECOS PAC ID: 6103890975 Enrollment ID: I20170629001468 |
| Provider Name | Jonathan R Kevan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1760534861 PECOS PAC ID: 5991985731 Enrollment ID: I20171013001859 |
| Provider Name | Kevin L Hamm |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1578657623 PECOS PAC ID: 8022919620 Enrollment ID: I20171014000017 |
| Provider Name | Christina E Vento |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1336262690 PECOS PAC ID: 0547390650 Enrollment ID: I20171019002747 |
| Provider Name | Yue-harn Ng |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1396932166 PECOS PAC ID: 6507938685 Enrollment ID: I20171114001967 |
| Provider Name | Robin Ross |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1720066285 PECOS PAC ID: 9335033513 Enrollment ID: I20171128002830 |
| Provider Name | Salam Chalouhi |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1538323332 PECOS PAC ID: 1557519550 Enrollment ID: I20180205000421 |
| Provider Name | Kathryn J Stuenkel |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1336568443 PECOS PAC ID: 7618195694 Enrollment ID: I20180208001528 |
| Provider Name | Esker M Arvanetes Ellis |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1073625547 PECOS PAC ID: 6507024924 Enrollment ID: I20180322001449 |
| Provider Name | Kira A Paisley |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1235405986 PECOS PAC ID: 3274788104 Enrollment ID: I20180605000084 |
| Provider Name | Samuel B Hancock |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1063672608 PECOS PAC ID: 3577699073 Enrollment ID: I20180614000232 |
| Provider Name | Julia D Knarreborg |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1952662363 PECOS PAC ID: 3173828803 Enrollment ID: I20180703001304 |
| Provider Name | Laura M Young |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1720048267 PECOS PAC ID: 9436109477 Enrollment ID: I20180813001041 |
| Provider Name | Robert N Jarman |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1992765390 PECOS PAC ID: 1052372968 Enrollment ID: I20180815000762 |
| Provider Name | Sandra Rajan |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1427544006 PECOS PAC ID: 5799034336 Enrollment ID: I20180815002618 |
| Provider Name | Alfred C Degner |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1891755294 PECOS PAC ID: 4082675996 Enrollment ID: I20180822000860 |
| Provider Name | Anastasia Mukamusoni |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568906626 PECOS PAC ID: 9133402829 Enrollment ID: I20180905001215 |
| Provider Name | Steven Matthew Wright |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1366733404 PECOS PAC ID: 0042536575 Enrollment ID: I20180912003056 |
| Provider Name | Kyle F Summers |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1346663135 PECOS PAC ID: 6406119593 Enrollment ID: I20180926000466 |
| Provider Name | Sarah Langham |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942668785 PECOS PAC ID: 9032416722 Enrollment ID: I20181015000917 |
| Provider Name | Ronald Stephen Pritchard |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1417998774 PECOS PAC ID: 2668426578 Enrollment ID: I20181016001073 |
| Provider Name | Nicole J Yonke |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1053514497 PECOS PAC ID: 2163692476 Enrollment ID: I20181030001549 |
| Provider Name | James P Cardasis |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1275590556 PECOS PAC ID: 4880750876 Enrollment ID: I20181113000343 |
| Provider Name | Shawn D Grant |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1043214497 PECOS PAC ID: 6204877079 Enrollment ID: I20181211000646 |
| Provider Name | Erin Murata Gordon |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1417273806 PECOS PAC ID: 4789801788 Enrollment ID: I20190906000283 |
| Provider Name | Guy Kulumau Goodness |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730602681 PECOS PAC ID: 5092073460 Enrollment ID: I20191016000959 |
| Provider Name | Aprilshandiin Curley-sherer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1184088627 PECOS PAC ID: 8022301977 Enrollment ID: I20191122000248 |
| Provider Name | Clarissa Juarez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225471154 PECOS PAC ID: 3971743675 Enrollment ID: I20191218000693 |
| Provider Name | Ashish Kataria |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1487975926 PECOS PAC ID: 0345476214 Enrollment ID: I20200109001510 |
| Provider Name | Sharon Nunez |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1245379239 PECOS PAC ID: 6204901424 Enrollment ID: I20200129000925 |
| Provider Name | Danielle T Chang |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1205298742 PECOS PAC ID: 7416240452 Enrollment ID: I20200213000597 |
| Provider Name | Summer H Nguyen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1790019917 PECOS PAC ID: 3173775103 Enrollment ID: I20200214001165 |
| Provider Name | Amanda C Lallensack |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1477178259 PECOS PAC ID: 0941626261 Enrollment ID: I20200818001365 |
| Provider Name | Jana Balas |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1396150652 PECOS PAC ID: 2163789678 Enrollment ID: I20201201002846 |
| Provider Name | Helen Reed |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1720433261 PECOS PAC ID: 3375956725 Enrollment ID: I20210105000218 |
| Provider Name | Maya M Green |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1205215894 PECOS PAC ID: 0648586933 Enrollment ID: I20210218000531 |
| Provider Name | Lisa A Goins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124373816 PECOS PAC ID: 5597915140 Enrollment ID: I20210224001975 |
| Provider Name | Kathryn Mcclain |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1053818013 PECOS PAC ID: 5395093678 Enrollment ID: I20210823002815 |
| Provider Name | Tanya C Dempsey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467034827 PECOS PAC ID: 2769887140 Enrollment ID: I20210824000079 |
| Provider Name | Morgan Dione Jones |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1417531286 PECOS PAC ID: 8921403338 Enrollment ID: I20210824001087 |
| Provider Name | Phuong M Nguyen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1578523874 PECOS PAC ID: 4587686621 Enrollment ID: I20210825000315 |
| Provider Name | Darren L Mancuso |
|---|---|
| Provider Type | Practitioner - Osteopathic Manipulative Medicine |
| Provider Identifiers | NPI Number: 1861521361 PECOS PAC ID: 5597700492 Enrollment ID: I20220228000541 |
| Provider Name | Chereta A Beverly |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205340056 PECOS PAC ID: 0446507941 Enrollment ID: I20220302000419 |
| Provider Name | Grace Rathna Francis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639621378 PECOS PAC ID: 4082009725 Enrollment ID: I20220316003180 |
| Provider Name | Manuel A Reyes |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1245281708 PECOS PAC ID: 1658412507 Enrollment ID: I20220808001322 |
| Provider Name | Erin Raye Flores |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1437884426 PECOS PAC ID: 9830565076 Enrollment ID: I20221013000999 |
| Provider Name | Matthew Kenny Mcelwee |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1831578590 PECOS PAC ID: 2769789478 Enrollment ID: I20221013001611 |
| Provider Name | John M Nwannunu |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1508199530 PECOS PAC ID: 6800930256 Enrollment ID: I20221017000151 |
| Provider Name | Jodi A B Punke |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1225148471 PECOS PAC ID: 0547363848 Enrollment ID: I20230209000412 |
| Provider Name | Katheryn Rose Barry |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1023343118 PECOS PAC ID: 7517254550 Enrollment ID: I20230331002005 |
| Provider Name | Patricia Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467909077 PECOS PAC ID: 5799111712 Enrollment ID: I20230607003268 |
| Provider Name | Katherine Henderson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235837766 PECOS PAC ID: 6507220415 Enrollment ID: I20230912000174 |
| Provider Name | Hannah C Imson |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1346925757 PECOS PAC ID: 5991153652 Enrollment ID: I20231120001003 |
| Provider Name | Casey R Smith |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1750910600 PECOS PAC ID: 2163849779 Enrollment ID: I20231214003191 |
| Provider Name | Kathleen A Lamphere |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093889735 PECOS PAC ID: 7214952449 Enrollment ID: I20231214003383 |
| Provider Name | Chaunte L Abe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902683816 PECOS PAC ID: 2668822560 Enrollment ID: I20231219000218 |
| Provider Name | Ellison Kaehr |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366132219 PECOS PAC ID: 3779947379 Enrollment ID: I20231223000107 |
| Provider Name | John C Jewett |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1932367851 PECOS PAC ID: 9638520778 Enrollment ID: I20240112002080 |
Double Happiness Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4104 Ponderosa Ave Ne, Albuquerque, NM 87110 Phone: 505-385-4127 Fax: 505-265-5041 | |
Albuquerque Internal Medicine Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4121 Montgomery Blvd Ne, Albuquerque, NM 87109 Phone: 505-314-0748 | |
Gabriella Good Md Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3015 Indian Farm Ln Nw, Albuquerque, NM 87107 Phone: 505-259-8694 Fax: 186-660-7177 | |
Hands On Health Care, P.c. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3825 Eubank Blvd Ne Ste C, Albuquerque, NM 87111 Phone: 505-298-8020 | |
Medicus Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 10401 Montgomery Pkwy Ne, Albuquerque, NM 87111 Phone: 505-234-1040 Fax: 505-293-7183 | |
New Mexico Neuromuscular Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2741 Indian School Rd Ne, Albuquerque, NM 87106 Phone: 505-255-8682 Fax: 505-255-7890 | |
Lovelace Healthcare Center-rio Bravo Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 200 Rio Bravo Blvd Se, Albuquerque, NM 87105 Phone: 505-873-6400 Fax: 505-873-6403 |