MANUEL BRANDON PACHECO IV (NPI# 1053969477) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053969477 |
| Entity Type | Individual |
| Full Name | MANUEL BRANDON PACHECO IV |
| Credential | MPAS, PA-C |
| Practice Address |
6400 Paseo Del Norte Ne Albuquerque NM 87113-1718 |
| Mailing Address |
Po Box 5122 Bernalillo NM 87004-5122 |
| Practice Telephone | 5055962100 |
| Mailing Telephone | 5052805336 |
| Enumeration Date | 2019-08-28 |
| Last Update Date | 2019-08-28 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | PA2019-0076 | NM | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982695284 | Manuel N Pacheco | Psychiatry & Neurology | 800 Washington St, Tufts Medical Center Box 1007, Boston, MA 02111-1552 | 2005-11-04 |
| Street Address |
6400 PASEO DEL NORTE NE |
| City | ALBUQUERQUE |
| State | NM |
| Zip Code | 87113-1718 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386789824 | Jane Jenab | Family Medicine | 6400 Paseo Del Norte Ne, Albuquerque, NM 87113-1718 | 2007-02-21 |
| 1891928669 | Elizabeth M White | Nurse Practitioner | 6400 Paseo Del Norte Ne, Albuquerque, NM 87113-1718 | 2009-08-27 |
| 1427187632 | Murray Forestell Young | Family Medicine | 6400 Paseo Del Norte Ne, Albuquerque, NM 87113-1718 | 2007-03-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952944613 | Wendy Valenciano Flores | Behavior Technician | 9019 Washington St Ne Building A, Albuquerque, NM 87113 | 2019-10-24 |
| 1336608504 | Southwestern Provider Services LLC | Registered Nurse | 6400 Paseo Del Norte, Albuquerque, NM 87113 | 2019-03-18 |
| 1376047795 | Anne K. Hempstead D.d.s., P.C. | Dentist | 6400 Holly Ave Ne Ste M, Albuquerque, NM 87113 | 2018-03-20 |
| 1447769518 | Ethan Grant | Behavior Technician | 8500 Washington St Ste A1, Albuquerque, NM 87113 | 2017-09-21 |
| 1215451083 | Sarah Bartlett | Behavior Technician | 8500 Washington St, Ste A1, Albuquerque, NM 87113 | 2017-08-02 |
| 1396109906 | Cathy A Walters | Specialist/Technologist | 532 Osuna Rd Ne, Albuquerque, NM 87113 | 2016-04-09 |
| 1518389824 | Esther Sanchez | Home Health Aide | 6800 Vista Del Norte Drive, 2814, Albuqerque, NM 87113 | 2014-01-07 |
| 1356775456 | Danielle Juliet Fichera | Social Worker | 315 Alameda Park Dr, Ne, Albuquerque, NM 87113 | 2013-08-26 |
| 1093053340 | Eagle Pointe Dentists and Orthodontics, LLC | Dentist | 6230 Paseo Del Norte Ne, Suite B, Albuquerque, NM 87113 | 2013-01-22 |
| 1922346428 | Keith Levitt | Anesthesiology | 8100 Wyoming Blvd Ne #712, Suite M4, Albuquerque, NM 87113 | 2013-01-18 |
| Find all providers in zip 87113 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609474550 | Mara Swartzentruber | Physician Assistant | 3310 Linda Vista Ave Se, Albuquerque, NM 87106-1514 | 2020-10-13 |
| 1336757301 | Dailey Doss | Physician Assistant | Raymond G. Murphy Va Medical Center, 1501 San Pedro Se, Albuquerque, NM 87108 | 2020-07-16 |
| 1487287413 | Thomas Clise | Physician Assistant | 629 San Pablo St Ne, Albuquerque, NM 87108-2137 | 2020-02-18 |
| 1912547324 | Kathleen Joyce L'heureux | Physician Assistant | 8124 Ventana Cielo Ave Nw, Albuquerque, NM 87114-5988 | 2020-01-14 |
| 1265097869 | Amber Zoubovitch | Physician Assistant | 7200 Montgomery Blvd Ne Ste 7121, Albuquerque, NM 87109-1510 | 2019-05-08 |
| 1639680739 | Wesley A Parker | Physician Assistant | 3777 Mdg, 2050a Second Street Se, Albuquerque, NM 87117-5522 | 2017-10-16 |
| 1003327487 | Elise Nicole Pedigo | Physician Assistant | 4700 Jefferson St Ne Ste 700, Albuquerque, NM 87109-2132 | 2017-10-12 |
| 1194170605 | Anna Marie Siow | Physician Assistant | 1014 Hummingbird Pl Sw, Albuquerque, NM 87105-8130 | 2016-05-03 |
| 1285032367 | Travis Householder | Physician Assistant | 201 Cedar St Se Ste 4610, Presbyterian Heart Group, Albuquerque, NM 87106-4936 | 2014-12-05 |
| 1508276973 | Stephanie Gonzales | Physician Assistant | 12241 Academy Rd Ne Ste 204, Albuquerque, NM 87111 | 2014-05-06 |
| Find all providers in ALBUQUERQUE | ||||
| City | ALBUQUERQUE |
| Zip Code | 87113 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.