DR. SHANE ANDREW GAILUSHAS (NPI# 1073786521) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073786521 |
| Entity Type | Individual |
| Full Name | DR. SHANE ANDREW GAILUSHAS |
| Credential | MD |
| Practice Address |
8200 Carmel Ave Ne Suite 102a Albuquerque NM 87122-2941 |
| Mailing Address |
1190 Spring Creek Pl Suite E1 Springville UT 84663-3045 |
| Practice Telephone | 5055140767 |
| Mailing Telephone | 8018529888 |
| Enumeration Date | 2008-04-04 |
| Last Update Date | 2015-07-29 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207YX0905X |
Otolaryngology Specialization: Otolaryngology/Facial Plastic Surgery |
MD2015-0203 | NM | Allopathic & Osteopathic Physicians |
| N | 207YX0905X |
Otolaryngology Specialization: Otolaryngology/Facial Plastic Surgery |
2013015482 | MO | Allopathic & Osteopathic Physicians |
| N | 207YX0905X |
Otolaryngology Specialization: Otolaryngology/Facial Plastic Surgery |
53757-20 | WI | Allopathic & Osteopathic Physicians |
| N | 207YX0905X |
Otolaryngology Specialization: Otolaryngology/Facial Plastic Surgery |
MED-PHYS-LIC-331 | MT | Allopathic & Osteopathic Physicians |
| Y | 207YX0905X |
Otolaryngology Specialization: Otolaryngology/Facial Plastic Surgery |
8995595-1205 | UT | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | 1073786521 | 05 |
| Street Address |
8200 CARMEL AVE NE SUITE 102A |
| City | ALBUQUERQUE |
| State | NM |
| Zip Code | 87122-2941 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730506494 | Life Enhancement Specialists LLC | Specialist | 8200 Carmel Ave Ne, Ste. 102, Albuquerque, NM 87122-2941 | 2014-03-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700426988 | Sophia Khalil | Student in an Organized Health Care Education/Training Program | 11128 Jordan Avenue Northeast, Albuquerque, NM 87122 | 2020-01-15 |
| 1457716664 | Raymond Martinez | Pharmacist | 7847 Tramway Ne, Albuquerque, NM 87122 | 2015-12-15 |
| 1891181913 | Paul Wright | Occupational Therapist | 30 Canocito Drive Ne, Albuquerque, NM 87122 | 2015-04-15 |
| 1356736615 | Tracy Pfeifer | Day Training/Habilitation Specialist | 8920 Holly Avenue Ne, Suite 102b, Albuquerque, NM 87122 | 2015-04-03 |
| 1346595071 | Jonathan Harper Kelley | Dentist | 9015 Paseo Del Norte Ne Ste A, Albuquerque, NM 87122 | 2012-07-18 |
| 1639444946 | Charlsey Leigh Mcdonald | Physical Therapist | 7920 Carmel Ave. Ne, Suite 2, Albuquerque, NM 87122 | 2012-03-20 |
| 1235462250 | Pamela Kay Limke | Pharmacist | 12112 Summer Wind Pl Ne, Albuquerque, NM 87122 | 2009-09-09 |
| 1437395332 | High Desert Pedicatrics PC | Pediatrics | 8650 Almeda Boulevard, Ne, Unit 101 E, Albuquerque, NM 87122 | 2008-12-23 |
| 1952427510 | Thomas Harry Heflin | Dentist | 8000 Carmel Ave, Albuquerque, NM 87122 | 2007-03-22 |
| 1497885032 | Thomas H Heflin Dds Pa | Dentist | 8000 Carmel Avenue Ne, Albuquerque, NM 87122 | 2007-03-06 |
| Find all providers in zip 87122 | ||||
| Taxonomy Code | 207YX0905X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Otolaryngology |
| Specialization | Otolaryngology/Facial Plastic Surgery |
| An otolaryngologist who specializes in the diagnosis and surgical treatment of head and neck conditions. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A General Certificate is issued by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841432473 | Tara Eileen Brennan | Otolaryngology | Unm Dept of Surgery Msc10 5610, 1 University of New Mexico, Albuquerque, NM 87131-0001 | 2009-03-27 |
| 1235335894 | Barry D. Nagel, Md, PC | Otolaryngology | 1020 Tijeras Ave Ne, Suite 22, Albuquerque, NM 87106-4749 | 2007-06-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023051232 | Peter M. Shepard | Otolaryngology | 1620 Hospital Dr, Southwestern Ear Nose and Throat Associates, Santa Fe, NM 87505-4754 | 2006-06-14 |
| 1487847174 | Byron Drake Erstine | Otolaryngology | 2907 Hillrise Dr, Las Cruces, NM 88011-4701 | 2007-08-25 |
| City | ALBUQUERQUE |
| Zip Code | 87122 |
Please comment or provide details below to improve the information on DR. SHANE ANDREW GAILUSHAS.
| 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.