UNIVERSITY OF NEW MEXICO MEDICAL GROUP, INC. (NPI# 1649431677) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649431677 |
| Entity Type | Organization |
| Organization Name | UNIVERSITY OF NEW MEXICO MEDICAL GROUP, INC. |
| Practice Address |
4700 Coal Ave Se Albuquerque NM 87108-2804 |
| Mailing Address |
University of New Mexico School Based Health Ctrs Msc09 5040 1 University of New Mexico Albuquerque NM 87131-0001 |
| Practice Telephone | 5052563363 |
| Practice Fax Number | 5052563363 |
| Mailing Telephone | 5052720457 |
| Mailing Fax Number | 5052722043 |
| Enumeration Date | 2008-06-23 |
| Last Update Date | 2008-06-23 |
| Authorized Official Name | MR. ANTHONY MASCIOTRA (CEO) |
| Authorized Official Telephone | 5052728950 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QS1000X |
Clinic/Center Specialization: Student Health |
88-PA05 | NM | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NM | 3A02 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043472111 | University of New Mexico Medical Group, Inc. | Clinic/Center | 700 Louisiana Se, Albuquerque, NM 87108 | 2008-06-30 |
| 1790946739 | University of New Mexico Medical Group, Inc. | Clinic/Center | 11799 State Highway 14 S, Tijeras, NM 87059-8619 | 2008-06-23 |
| 1518129683 | University of New Mexico Medical Group, Inc. | Clinic/Center | 1138 Cardenas Dr Se, Albuquerque, NM 87108-4809 | 2008-06-30 |
| 1427210590 | University of New Mexico Medical Group, Inc. | Clinic/Center | 415 Thaxton Ave Se, Albuquerque, NM 87102-4855 | 2008-06-30 |
| 1992966923 | University of New Mexico Medical Group, Inc. | Clinic/Center | 800 Odelia Rd Ne, Albuquerque, NM 87102-1619 | 2008-06-23 |
| Street Address |
4700 COAL AVE SE |
| City | ALBUQUERQUE |
| State | NM |
| Zip Code | 87108-2804 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194877308 | Timothea Elizalde | Social Worker | 4700 Coal Ave Se, Highland Hs, Albuquerque, NM 87108-2804 | 2007-01-17 |
| 1073155537 | Jody Wood | Speech-Language Pathologist | 4700 Coal Ave Se, Albuquerque, NM 87108-2804 | 2019-10-16 |
| 1114483328 | Dawn Chavez-branch | Registered Nurse | 4700 Coal Ave Se, Albuquerque, NM 87108-2804 | 2019-02-12 |
| 1760992697 | Colleen Gonzales | Social Worker | 4700 Coal Ave Se, Albuquerque, NM 87108-2804 | 2017-10-05 |
| 1871983015 | Daniel Paz-rudolph | Specialist/Technologist | 4700 Coal Ave Se, Albuquerque, NM 87108-2804 | 2015-01-26 |
| 1457776668 | Albuquerque Public Schools | Local Education Agency (LEA) | 4700 Coal Ave Se, Albuquerque, NM 87108-2804 | 2014-02-25 |
| 1265770994 | Catherine Ann Kroll | Social Worker | 4700 Coal Ave Se, Highland Hs, Albuquerque, NM 87108-2804 | 2013-01-31 |
| 1316076912 | Gilbert A Ramirez | Social Worker | 4700 Coal Ave Se, Highland Hs, Albuquerque, NM 87108-2804 | 2007-03-02 |
| 1407995376 | Natalie D Hathorn | Speech-Language Pathologist | 4700 Coal Ave Se, Highland Hs, Albuquerque, NM 87108-2804 | 2007-02-06 |
| 1659423432 | Cynthia Ramirez | Social Worker | 4700 Coal Ave Se, Highland Hs, Albuquerque, NM 87108-2804 | 2007-01-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588274393 | Aubrey Bunnenberg | Behavior Technician | 114 Pennsyvlania St. Ne Apt. 1, Albuquerque, NM 87108 | 2020-08-06 |
| 1336757301 | Dailey Doss | Physician Assistant | Raymond G. Murphy Va Medical Center, 1501 San Pedro Se, Albuquerque, NM 87108 | 2020-07-16 |
| 1457990046 | Christine Lovato | Registered Nurse | Albuquerque Treatment Services LLC, 123 Madeira Dr Se, Albuquerque, NM 87108 | 2019-12-30 |
| 1265074405 | Andrew Jacob Reuter | Pharmacist | 3816 Copper Ave Ne, Unit A, Albuquerque, NM 87108 | 2019-10-09 |
| 1518517325 | Lillian Abeyta | Technician | 1501 San Pedro Dr Se., Albuquerque, NM 87108 | 2019-09-13 |
| 1962970061 | Donald Borrego | Occupational Therapy Assistant | 5200 Copper Ne, #7, Albuquerque, NM 87108 | 2018-11-06 |
| 1154808012 | Catalina Castro | Social Worker | 209 San Pablo Se, Albuquerque, NM 87108 | 2018-07-24 |
| 1942721048 | Walgreen Co | Pharmacy | 933 San Mateo Blvd Ne Ste 501, Albuquerque, NM 87108 | 2017-06-29 |
| 1467981860 | Jennifer Martinez | Behavior Technician | 628 Espanola Se, Albuquerque, NM 87108 | 2017-06-08 |
| 1457892465 | J Dowd Counseling LLC | Counselor | 514 Monroe Street Se, Albuquerque, NM 87108 | 2017-03-10 |
| Find all providers in zip 87108 | ||||
| Taxonomy Code | 261QS1000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Student Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740784198 | Fnch Sbhc Naca High School | Clinic/Center | 1711 Stanford Dr Ne, Albuquerque, NM 87106-2535 | 2018-03-21 |
| 1043472111 | University of New Mexico Medical Group, Inc. | Clinic/Center | 700 Louisiana Se, Albuquerque, NM 87108 | 2008-06-30 |
| 1043661010 | University of New Mexico Medical Group Inc | Clinic/Center | 933 Bradbury Dr Se, Suite 2222, Albuquerque, NM 87106-4374 | 2016-06-30 |
| 1114307071 | Owens Administrative & Healthcare Support Services | Clinic/Center | 4300 Blake Rd Sw, Albuquerque, NM 87121-5179 | 2015-06-05 |
| 1699166140 | Sandia National Laboratories | Clinic/Center | 1515 Eubank Blvd Se Bldg. 831/832, Albuquerque, NM 87185-1019 | 2015-02-05 |
| 1174965610 | Presbyterian Medical Services | Clinic/Center | 1138 Cardenas Dr Se, Albuquerque, NM 87108-4809 | 2013-07-25 |
| 1598107039 | Presbyterian Medical Services | Clinic/Center | 1111 Easterday Dr Ne, Albuquerque, NM 87112-5115 | 2013-07-25 |
| 1043461163 | University of New Mexico | Clinic/Center | 1111 Easterday Dr Ne, Albuquerque, NM 87112-5115 | 2008-10-07 |
| 1518129683 | University of New Mexico Medical Group, Inc. | Clinic/Center | 1138 Cardenas Dr Se, Albuquerque, NM 87108-4809 | 2008-06-30 |
| 1427210590 | University of New Mexico Medical Group, Inc. | Clinic/Center | 415 Thaxton Ave Se, Albuquerque, NM 87102-4855 | 2008-06-30 |
| Find all providers in ALBUQUERQUE | ||||
| City | ALBUQUERQUE |
| Zip Code | 87108 |
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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.