DR. GAUTAM KISHORE VALECHA (NPI# 1235579632) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235579632 |
| Entity Type | Individual |
| Full Name | DR. GAUTAM KISHORE VALECHA |
| Credential | MBBS |
| Practice Address |
8300 Constitution Ave Ne Albuquerque NM 87110-7613 |
| Mailing Address |
Po Box 26666 Phs Provider Enrollment Albuquerque NM 87125-6666 |
| Practice Telephone | 5055596100 |
| Practice Fax Number | 5055596101 |
| Mailing Telephone | 5059236770 |
| Enumeration Date | 2013-06-28 |
| Last Update Date | 2020-06-23 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RH0003X |
Internal Medicine Specialization: Hematology & Oncology |
MD2020-0359 | NM | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Street Address |
8300 CONSTITUTION AVE NE |
| City | ALBUQUERQUE |
| State | NM |
| Zip Code | 87110-7613 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386641876 | Mahmood Reza Zamanian | Internal Medicine | 8300 Constitution Ave Ne, Albuquerque, NM 87110-7613 | 2005-06-30 |
| 1972123511 | Kate Marcus | Occupational Therapist | 8300 Constitution Ave Ne, Albuquerque, NM 87110-7613 | 2020-04-23 |
| 1033756887 | Grady Fowler | Physician Assistant | 8300 Constitution Ave Ne, Albuquerque, NM 87110-7613 | 2019-11-27 |
| 1306498860 | Carly Pecoriello Nowicki | Nurse Practitioner | 8300 Constitution Ave Ne, Albuquerque, NM 87110-7613 | 2019-07-15 |
| 1255806543 | Donna Renee Whalen | Nurse Practitioner | 8300 Constitution Ave Ne, Albuquerque, NM 87110-7613 | 2018-10-12 |
| 1972003119 | Whitney Wyers | Nurse Practitioner | 8300 Constitution Ave Ne, Albuquerque, NM 87110-7613 | 2018-02-14 |
| 1215436050 | Joanne Elaine Greer | Nurse Practitioner | 8300 Constitution Ave Ne, Albuquerque, NM 87110-7613 | 2018-02-07 |
| 1447759659 | Monica Nmi Martinez | Nurse Practitioner | 8300 Constitution Ave Ne, Albuquerque, NM 87110-7613 | 2018-02-03 |
| 1386142792 | Jenny Pilkey | Nurse Practitioner | 8300 Constitution Ave Ne, Albuquerque, NM 87110 | 2018-01-31 |
| 1215443130 | Andrea E Owens | Nurse Practitioner | 8300 Constitution Ave Ne, Albuquerque, NM 87110-7613 | 2017-12-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215550199 | Sabrina Jennifer Lujan | Counselor | 8401 Constitution Ave Nw, Albuquerque, NM 87110 | 2020-05-26 |
| 1649829318 | Robert D. Oliver | Technician | 2705 Texas Street Ne, Albuquerque, NM 87110 | 2019-09-05 |
| 1033770904 | Life Re-created LLC | Counselor | 3939 San Pedro Dr. Ne, Bld C, Ste 8, Albuquerque, NM 87110 | 2019-06-21 |
| 1497319693 | Clear Choice Vision Care, LLC | Optometrist | 6600 Menaul Blve Ne, Suite M5a, Albuquerque, NM 87110 | 2019-04-24 |
| 1790257558 | Diana M Nicolas | Dietitian, Registered | 8300 Constitution Ave Ne Bld D, Albuquerque, NM 87110 | 2018-12-18 |
| 1689168403 | Robin N Hermes, Md, PC | Anesthesiology | 2440 Lousiana Blvd. Ne, Ste 580, Albuquerque, NM 87110 | 2018-06-15 |
| 1710481726 | Desert Mountain Eyecare LLC | Optometrist | 5504 Menaul Blvd Ne Ste Aandb, Albuquerque, NM 87110 | 2018-03-23 |
| 1659873131 | Amanda Lacasse | Registered Nurse | 6400 Uptown Blvd Ne Suite 360 West, Albuquerque, NM 87110 | 2018-03-01 |
| 1518485655 | Danielle Liegh Wyne | Counselor | 6121 Indian School Rd, Suite 141, Albuquerque, NM 87110 | 2017-09-08 |
| 1265957237 | Myrrhine Faller | Speech-Language Pathologist | 6020 Constitution Ave. Ne, Suite 4, Albuquerque, NM 87110 | 2017-08-10 |
| Find all providers in zip 87110 | ||||
| Taxonomy Code | 207RH0003X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Hematology & Oncology |
| An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2007. [7/1/2008: definiton added, source added; 7/1/2011: modified source] - Additional Resources: http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033435490 | Heloisa Prado Soares | Internal Medicine | Msc07 4025 1 University of Nm, Albuquerque, NM 87131-9416 | 2010-04-10 |
| 1487743092 | Wadih Arap | Internal Medicine | 1 University of New Mexico Msc 07 4025, 1201 Camino De Salud, Albuquerque, NM 87131-0001 | 2006-10-12 |
| 1114990298 | Murray M Bern | Internal Medicine | Unm Cancer Ctr, Msc 07-4025 1201 Camino De Salud, Albuquerque, NM 87131-0001 | 2006-02-09 |
| 1073506531 | Kenneth J Smith | Internal Medicine | 8300 Constitution Ave. Ne, Presbyterian Oncology Kaseman Hospital, Albuquerque, NM 87110-7613 | 2005-08-30 |
| 1114920238 | Douglas A. Clark | Internal Medicine | 4901 Lang Ave Ne, Albuquerque, NM 87109-4397 | 2005-05-23 |
| 1790183135 | Lovelace Health System, LLC | Internal Medicine | 715 Dr Martin Luther King Jr Ave Ne, Suite 102, Albuquerque, NM 87102-3661 | 2014-12-17 |
| 1326393380 | Neda Hashemi Sadraei | Internal Medicine | 1 University of New Mexico, Albuquerque, NM 87131 | 2012-07-16 |
| 1184980989 | Paul Allen Brittain | Internal Medicine | 715 Dr Martin Luther King Jr Ave Ne Ste 102, Albuquerque, NM 87102 | 2012-04-05 |
| 1972824084 | Emrullah Yilmaz | Internal Medicine | 933 Bradbury Dr Se, Suite 2222, Albuquerque, NM 87106-4374 | 2010-06-14 |
| 1023342466 | Rubens Barros Costa Filho | Internal Medicine | 715 Dr Martin Luther King Jr Ave Ne, Suite 102, Albuquerque, NM 87102-3661 | 2009-10-01 |
| Find all providers in ALBUQUERQUE | ||||
| City | ALBUQUERQUE |
| Zip Code | 87110 |
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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.