TINA M. WATTERBERG (NPI# 1316932817) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316932817 |
| Entity Type | Individual |
| Full Name | TINA M. WATTERBERG |
| Credential | M.D. |
| Practice Address |
5757 Harper Drive Ne Albuquerque NM 87109 |
| Mailing Address |
8801 Horizon Blvd Ne Suite 360 Albuquerque NM 87113-1533 |
| Practice Telephone | 5058885757 |
| Practice Fax Number | 5058893589 |
| Mailing Telephone | 5058284923 |
| Mailing Fax Number | 5052130103 |
| Enumeration Date | 2005-09-12 |
| Last Update Date | 2008-04-25 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207W00000X | Ophthalmology | 83-152 | NM | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NM | RRB MEDICARE RAILROAD | 180014480 | 01 |
| AZ | 279697 | 05 | |
| NM | 3103 | 05 | |
| NM | BC BS OF NM | NM002884 | 01 |
| Street Address |
5757 HARPER DRIVE NE |
| City | ALBUQUERQUE |
| State | NM |
| Zip Code | 87109 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326048307 | Thomas J. Carlow | Ophthalmology | 5757 Harper Drive Ne, Albuquerque, NM 87109 | 2005-07-29 |
| 1912044348 | Eye Associates of New Mexico, Ltd. | Optometrist | 5757 Harper Drive Ne, Albuquerque, NM 87109 | 2007-02-01 |
| 1861427841 | Cara Ann Morris | Optometrist | 5757 Harper Drive Ne, Albuquerque, NM 87109 | 2006-07-11 |
| 1972567154 | Kenneth S Himmel | Ophthalmology | 5757 Harper Drive Ne, Albuquerque, NM 87109 | 2006-04-14 |
| 1376533240 | Mark P. Lesher | Ophthalmology | 5757 Harper Drive Ne, Albuquerque, NM 87109 | 2005-10-24 |
| 1205826203 | Gregory S.h. Ogawa | Ophthalmology | 5757 Harper Drive Ne, Albuquerque, NM 87109 | 2005-10-21 |
| 1700871894 | Arthur J. Weinstein | Ophthalmology | 5757 Harper Drive Ne, Albuquerque, NM 87109 | 2005-09-14 |
| 1316932437 | Frank J Mares | Ophthalmology | 5757 Harper Drive Ne, Albuquerque, NM 87109 | 2005-09-14 |
| 1295720621 | Michael L Dimonaco | Ophthalmology | 5757 Harper Drive Ne, Albuquerque, NM 87109 | 2005-09-12 |
| 1275528606 | Frank Durso | Ophthalmology | 5757 Harper Drive Ne, Albuquerque, NM 87109 | 2005-09-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386286367 | Mikaela Epaloose | Behavior Technician | 100 Sun Avenue N.e., Suite 650, Albuquerque, NM 87109 | 2019-10-11 |
| 1245872464 | Marsha Director | Behavior Technician | 100 Sun Avenue Ne, Ste 650, Albuquerque, NM 87109 | 2019-10-09 |
| 1720637499 | Nancy Gail Vice | Technician | 7319 Laguna Niguel Drive Ne, Albuquerque, NM 87109 | 2019-09-05 |
| 1598314411 | Chau Vu | Behavior Technician | Attn: Behavioral Health Works 100 Sun Avenue N.e., Suite 650, Albuquerque, NM 87109 | 2019-09-04 |
| 1932753498 | Noelle Nielsen | Behavior Technician | 6401 Academy Rd. Ne Apt. 189, Albuquerque, NM 87109 | 2019-08-01 |
| 1952967952 | Caridad Merkel | Obstetrics & Gynecology | 6100 Pan American Fwy Ne Suite 450, Albuquerque, NM 87109 | 2019-05-15 |
| 1043795149 | Margaret Mcconville | Physical Therapist | Lovelace Women's Hospital Outpatient Rehabilitation, 4600 Montgomery Blvd Ne, Albuquerque, NM 87109 | 2018-09-25 |
| 1922586262 | Clark Endodontics LLC | Dentist | 7520 Montgomery Blvd Ne Bldg E1, Albuquerque, NM 87109 | 2018-07-30 |
| 1447736202 | Melissa Christine Scott | Registered Nurse | Lovelace Women's Hospital, 4701 Montgomery Blvd Ne, Albuquerque, NM 87109 | 2018-07-16 |
| 1508351990 | Gianna Nicole Casarez-quintana | Dentist | 7520 Montgomery Blvd Ne Bldg E10, Albuquerque, NM 87109 | 2018-06-27 |
| Find all providers in zip 87109 | ||||
| Taxonomy Code | 207W00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Ophthalmology |
| An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Ophthalmology, 2007. http://www.abop.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Ophthalmology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285007112 | Kenneth P. Goldblum, M.d., Ltd. | Ophthalmology | 26 Tierra Monte St Ne, Albuquerque, NM 87122-2102 | 2015-10-30 |
| 1568856417 | Qinyun Wang | Ophthalmology | 8801 Horizon Blvd Ne Ste 360, Albuquerque, NM 87113-1563 | 2015-03-27 |
| 1982976361 | Ernest Harry Christman | Ophthalmology | 1055 Matador Dr Se, Albuquerque, NM 87123-4222 | 2012-02-01 |
| 1881961290 | Kenneth P. Adams, D.o.,p.c | Ophthalmology | 12412 Pristine Court Northeast, Albuquerque, NM 87122-4315 | 2011-11-30 |
| 1790071140 | Philip James Sanchez | Ophthalmology | 5757 Harper Drive, Ne, Eye Associates of New Mexico, Albuquerque, NM 87109 | 2011-06-23 |
| 1871886408 | Alexander Shin Davis | Ophthalmology | 1 University of New Mexico # 105610, Albuquerque, NM 87131-0001 | 2011-05-16 |
| 1972733608 | Rachel Davis | Ophthalmology | Department of Surgery Ophthalmology, Msc10-5610 1 University of New Mexico, Albuquerque, NM 87131-0001 | 2009-07-15 |
| 1942477971 | Patrick Chan | Ophthalmology | 6401 Holly Ave Ne, Albuquerque, NM 87113-2474 | 2008-05-08 |
| 1891972733 | Jerome W Bettman Jr. | Ophthalmology | 2727 San Pedro Drive, N.e., Suite 115, Albuquerque, NM 87110-3364 | 2008-01-23 |
| 1730394438 | Stephen Charles Coleman | Ophthalmology | 5051 Journal Center Blvd Ne, Albuquerque, NM 87109-5903 | 2007-05-14 |
| Find all providers in ALBUQUERQUE | ||||
| City | ALBUQUERQUE |
| Zip Code | 87109 |
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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.