DR. OTONIEL R SULLESTA (NPI# 1295816148) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295816148 |
| Entity Type | Individual |
| Full Name | DR. OTONIEL R SULLESTA |
| Credential | MD |
| Practice Address |
2430 W Pierce St Carlsbad Medical Center Carlsbad NM 88220 |
| Mailing Address |
411 N Canyon Carlsbad NM 88220 |
| Practice Telephone | 5758874150 |
| Mailing Telephone | 5758870323 |
| Mailing Fax Number | 5758878018 |
| Enumeration Date | 2006-10-18 |
| Last Update Date | 2008-05-16 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
82319 | NM | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NM | 28902 | 05 |
| Street Address |
2430 W PIERCE ST CARLSBAD MEDICAL CENTER |
| City | CARLSBAD |
| State | NM |
| Zip Code | 88220 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194723494 | Daniel Forest Taylor | Family Medicine | 2430 W Pierce St, Carlsbad, NM 88220-3553 | 2005-07-11 |
| 1740819762 | Carlsbad Medical Center LLC | Clinical Medical Laboratory | 2430 W Pierce St, Carlsbad, NM 88220-3553 | 2020-04-02 |
| 1578027710 | Cassandra Groves | Registered Nurse | 2430 W Pierce St, Carlsbad, NM 88220-3553 | 2019-01-22 |
| 1578046181 | Cally Vetter | Dietitian, Registered | 2430 W Pierce St, Carlsbad, NM 88220-3553 | 2018-09-10 |
| 1992200141 | Scott Christian Phillips | Nurse Anesthetist, Certified Registered | 2430 W Pierce St, Carlsbad, NM 88220-3553 | 2018-03-29 |
| 1467956862 | Courtney Allison Wittkower | Physical Therapist | 2430 W Pierce St, Carlsbad, NM 88220-3597 | 2018-03-20 |
| 1073016549 | Andrew Jason Costin | Nurse Anesthetist, Certified Registered | 2430 W Pierce St, Carlsbad, NM 88220-3553 | 2018-03-12 |
| 1053827832 | Cameron Scott Peterson | Nurse Anesthetist, Certified Registered | 2430 W Pierce St, Carlsbad, NM 88220-3553 | 2017-12-15 |
| 1184137093 | Carlsbad Medical Center LLC | Medicare Defined Swing Bed Unit | 2430 W Pierce St, Carlsbad, NM 88220-3553 | 2017-11-14 |
| 1073036174 | Devin Holt | Nurse Anesthetist, Certified Registered | 2430 W Pierce St, Carlsbad, NM 88220-3553 | 2017-07-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083248991 | Diana P Levy | Nurse Anesthetist, Certified Registered | Carlsbad Medical Center, 2430 W Pierce St., Carlsbad, NM 88220 | 2020-02-29 |
| 1790333680 | Angela Houston | Nurse Practitioner | 202 W. Church Street, Carlsbad, NM 88220 | 2019-09-03 |
| 1265958722 | Amanda Henry | Social Worker | 3000, West Church Street, Carlsbad, NM 88220 | 2017-08-16 |
| 1952827610 | Audriana B Martinez | Physical Therapy Assistant | 1038 Pinon Ln, Carlsbad, NM 88220 | 2017-08-15 |
| 1730538265 | Amber Bojorquez | Registered Nurse | 406 N. Alameda St., Carlsbad, NM 88220 | 2016-06-06 |
| 1164887584 | Kassandra Prutsman | Specialist | 126 S. Canyon, Carlsbad, NM 88220 | 2015-12-30 |
| 1306220314 | Rocky Mountain Holdings, LLC | Ambulance | 1505 Terminal Dr, Carlsbad, NM 88220 | 2015-07-20 |
| 1578986402 | Sheryl L Dugger | Registered Nurse | 406 N. Alameda, Carlsbad, NM 88220 | 2014-01-29 |
| 1194153106 | Wellcare, Inc. | Hospice Care, Community Based | 220 S Canal St Ste B, Carlsbad, NM 88220 | 2013-10-30 |
| 1932537420 | Wellcare, Inc | Home Health | 220 S Canal St Ste A, Carlsbad, NM 88220 | 2013-10-22 |
| Find all providers in zip 88220 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083154827 | Quantum Medical Radiology of California, P.C. | Radiology | 1412 Sapphire Dr, Carlsbad, CA 92011-1200 | 2017-02-27 |
| 1992936652 | Kennewick Radiology Group PC | Radiology | 3548 Avenida Pantera, Carlsbad, CA 92009-8939 | 2009-07-29 |
| 1104083377 | Sutter Gould Medical Foundation | Radiology | 3585 Gorge Pl, Carlsbad, CA 92010-7083 | 2008-05-16 |
| 1205917150 | Medical Imaging of Carlsbad Pa | Radiology | 411 N Canyon, Carlsbad Medical Center, Carlsbad, NM 88220 | 2006-10-18 |
| 1386742401 | Afsaneh Maghsoudy | Radiology | 6010 Hidden Valley Rd Ste 125, Carlsbad, CA 92011-4219 | 2006-09-20 |
| 1073619094 | Barry Blair Campbell | Radiology | 7141 Argonauta Way, Carlsbad, CA 92009-6507 | 2006-09-16 |
| 1972609121 | Lon Babbitt | Radiology | 1803 Mountain Shadow Dr, Carlsbad, NM 88220-4150 | 2006-09-15 |
| 1770554701 | Teresa Anne Deroo | Radiology | 5456 Wolverine Ter, Carlsbad, CA 92010-7159 | 2006-01-28 |
| 1730554551 | Sutter Valley Medical Foundation | Radiology | 3585 Gorge Pl, Carlsbad, CA 92010-7083 | 2015-12-04 |
| 1730278656 | Am & Bb Imaging Center Inc | Radiology | 6010 Hidden Valley Rd, Suite 125, Carlsbad, CA 92011-4213 | 2006-10-11 |
| Find all providers in CARLSBAD | ||||
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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.