| Visavis Health Care Medical Group Of Nm Llc | |
|
103 Hospital Loop Ne Albuquerque NM 87109-2115 | |
| (929) 491-7333 | |
| Not Available |
| Full Name | Visavis Health Care Medical Group Of Nm Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 103 Hospital Loop Ne, Albuquerque, New Mexico |
| Authorized Official Name and Position | Rekha Bhandari (OWNER) |
| Authorized Official Contact | 7185340689 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Visavis Health Care Medical Group Of Nm Llc 1481 Mcdonald Ave Fl 2 Brooklyn NY 11230-4667 Ph: () - | Visavis Health Care Medical Group Of Nm Llc 103 Hospital Loop Ne Albuquerque NM 87109-2115 Ph: (929) 491-7333 |
| NPI Number | 1598459042 |
|---|---|
| Provider Enumeration Date | 06/07/2023 |
| Last Update Date | 06/07/2023 |
| Medicare PECOS PAC ID | 2163878497 |
|---|---|
| Medicare Enrollment ID | O20231024000131 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598459042 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Jason Rotonda |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023596491 PECOS PAC ID: 9830441567 Enrollment ID: I20181009000141 |
| Provider Name | Kristina Nicole Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255713665 PECOS PAC ID: 0648583773 Enrollment ID: I20191101000124 |
| Provider Name | Bettina Bellamy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891364774 PECOS PAC ID: 4587067764 Enrollment ID: I20220413001412 |
| Provider Name | Jeriann Courtney Peter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639405434 PECOS PAC ID: 5193867513 Enrollment ID: I20230920000153 |
| Provider Name | Heriberto Figueroa |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093312480 PECOS PAC ID: 8123430253 Enrollment ID: I20231107002635 |
| Provider Name | Jenna Michelle Koepke |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851848352 PECOS PAC ID: 8426346826 Enrollment ID: I20231110001618 |
| Provider Name | Marie Perkowski |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356686059 PECOS PAC ID: 9931340908 Enrollment ID: I20231112000115 |
| Provider Name | Julia Didesiderio |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548717192 PECOS PAC ID: 9537441993 Enrollment ID: I20231114002678 |
| Provider Name | Mariama Hubbard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518946763 PECOS PAC ID: 8628033156 Enrollment ID: I20231122000013 |
| Provider Name | Pramila Baral |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295333144 PECOS PAC ID: 0840603767 Enrollment ID: I20231201000813 |
| Provider Name | Bridgett Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629580519 PECOS PAC ID: 3375931702 Enrollment ID: I20231201001940 |
| Provider Name | Bethel Ubochi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063831824 PECOS PAC ID: 6204288343 Enrollment ID: I20240115000256 |
| Provider Name | Derek Harpole |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235771874 PECOS PAC ID: 3779914965 Enrollment ID: I20240221001855 |
| Provider Name | Deanna Denise Desire |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568180594 PECOS PAC ID: 6204203391 Enrollment ID: I20240229001427 |
| Provider Name | Mercedes Jane Bryce |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770294340 PECOS PAC ID: 1658743398 Enrollment ID: I20240329002579 |
| Provider Name | Sharon Nchonko |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861978389 PECOS PAC ID: 9638573066 Enrollment ID: I20240520003571 |
| Provider Name | Ramon Trinidad |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588211627 PECOS PAC ID: 2860829355 Enrollment ID: I20241217002541 |
| Provider Name | Chayna Hardy-reid |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508331778 PECOS PAC ID: 9133465057 Enrollment ID: I20250118000006 |
| Provider Name | Frances Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417016999 PECOS PAC ID: 5597734194 Enrollment ID: I20250311003941 |
| Provider Name | Chantz Bury |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356990261 PECOS PAC ID: 3971834375 Enrollment ID: I20250322000163 |
| Provider Name | Kristina Brown |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730530908 PECOS PAC ID: 9234491283 Enrollment ID: I20250605003880 |
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