DR. BENJAMIN LEE WAGENMAN (NPI# 1467636951) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467636951 |
| Entity Type | Individual |
| Full Name | DR. BENJAMIN LEE WAGENMAN |
| Credential | MD |
| Practice Address |
1100 Central Ave Se Phs- Lab - S1 Level Albuquerque NM 87106-4930 |
| Practice Telephone | 5058411330 |
| Mailing Telephone | 5058411330 |
| Enumeration Date | 2007-12-20 |
| Last Update Date | 2012-11-26 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207ZC0006X |
Pathology Specialization: Clinical Pathology |
MD2011-0037 | NM | Allopathic & Osteopathic Physicians |
| Street Address |
1100 CENTRAL AVE SE PHS- LAB - S1 LEVEL |
| City | ALBUQUERQUE |
| State | NM |
| Zip Code | 87106-4930 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457354243 | Robert A Biazak | Anesthesiology | 1100 Central Ave Se, Albuquerque, NM 87106-4930 | 2005-05-24 |
| 1043811045 | Nathan Michael Mabon | Registered Nurse | 1100 Central Ave Se, Albuquerque, NM 87106-4934 | 2020-11-05 |
| 1588274039 | Caryn Hong Thi Nguyen | Pharmacist | 1100 Central Ave Se, Albuquerque, NM 87106-4930 | 2020-08-07 |
| 1396355996 | Hope Jessica Montoya | Internal Medicine | 1100 Central Ave Se, Albuquerque, NM 87106-4930 | 2020-08-07 |
| 1326658030 | Chaniece Doyle | Pharmacist | 1100 Central Ave Se, Albuquerque, NM 87106-4930 | 2020-08-06 |
| 1598375495 | Daniel Sanchez | Pharmacist | 1100 Central Ave Se, Albuquerque, NM 87106-4930 | 2020-08-05 |
| 1215551478 | Yousuf Shakir | Pharmacist | 1100 Central Ave Se, Albuquerque, NM 87106-4930 | 2020-06-03 |
| 1861037715 | Jeffrey Lillie | Nurse Anesthetist, Certified Registered | 1100 Central Ave Se, Albuquerque, NM 87106-4930 | 2019-11-14 |
| 1396387502 | Justin Schmetterer | Pharmacist | 1100 Central Ave Se, Albuquerque, NM 87106-4930 | 2019-10-09 |
| 1669023602 | Jalayne Faulhaber | Nurse Practitioner | 1100 Central Ave Se, Albuquerque, NM 87106-4930 | 2019-09-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629679808 | Jorge Licano | Student in an Organized Health Care Education/Training Program | Unmh Hospital 2211 Lomas Blvd Ne, Albuquerque, NM 87106 | 2020-11-04 |
| 1730780032 | Joseph Sanchez | Student in an Organized Health Care Education/Training Program | (unmh Hospital 2211 Lomas Blvd Ne, Albuquerque, NM 87106 | 2020-11-03 |
| 1336746205 | Evan Laub | Pharmacist | 2950 Central Ave. Sw, Albuquerque, NM 87106 | 2020-10-05 |
| 1487203154 | Theresa Martinez | Technician | 5680 Avedon Dr. Se, Albuquerque, NM 87106 | 2019-09-05 |
| 1205300647 | Louis Mayer II | Specialist/Technologist | 1414 University Blvd Tow Diehm Athletic Facility, Albuquerque, NM 87106 | 2019-01-18 |
| 1235633355 | Terrena Grace Vigil Brady | Occupational Therapist | 1001 Yale Blvd, Albuquerque, NM 87106 | 2018-03-22 |
| 1205355195 | Yaritza Ruiz | Specialist/Technologist | 1200 Avenida Cesar Chavez, 231d, Albuquerque, NM 87106 | 2017-09-12 |
| 1457873382 | Cynthia Bluhm | Registered Nurse | 7600 Cedar St Se Ste 7600, Albuquerque, NM 87106 | 2017-07-12 |
| 1295265882 | Hallie Chancellor | Behavior Technician | 1801 Gibson Blvd Se Apt 1046, Albuquerque, NM 87106 | 2017-06-15 |
| 1780111757 | Jiana Hook | Physical Medicine & Rehabilitation | 1414 University Blvd. Se, Albuquerque, NM 87106 | 2017-05-22 |
| Find all providers in zip 87106 | ||||
| Taxonomy Code | 207ZC0006X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pathology |
| Specialization | Clinical Pathology |
| A pathologist deals with the causes and nature of disease and contributes to diagnosis, prognosis and treatment through knowledge gained by the laboratory application of the biologic, chemical and physical sciences. A pathologist uses information gathered from the microscopic examination of tissue specimens, cells and body fluids, and from clinical laboratory tests on body fluids and secretions for the diagnosis, exclusion and monitoring of disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: new, 7/1/2009: definition reformatted] Additional Resources: American Board of Pathology, 2007. http://www.abpath.org/ This taxonomy code identifies the combined anatomic "clinical pathology only" route. Board Certification for Medical Doctors (MDs) is provided by the American Board of Pathology. To acknowledge the diverse activities in the practice of pathology and to accommodate the interests of individuals wanting to enter the field, the ABP offers primary certification through the following three routes: combined anatomic pathology and clinical pathology, anatomic pathology only and clinical pathology only. Primary certification in anatomic pathology or clinical pathology may be combined with some of the subspecialty certifications. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548675473 | Jonny Lorraine Salyer | Pathology | 2441 Ridgecrest Dr Se, Albuquerque, NM 87108-5129 | 2014-06-30 |
| 1023374162 | Jennifer L Wheeler Buenger | Pathology | Msc 10 5590, 1 University of New Mexico, Albuquerque, NM 87131-0001 | 2012-04-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235634346 | Zia Healthcare Services LLC | Pathology | 168 Hospital Dr, Raton, NM 87740 | 2018-03-29 |
| City | ALBUQUERQUE |
| Zip Code | 87106 |
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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.