VISTA EMERGENCY PHYSICIANS (NPI# 1699885517) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699885517 |
| Entity Type | Organization |
| Organization Name | VISTA EMERGENCY PHYSICIANS |
| Practice Address |
1016 E Roosevelt Ave Grants NM 87020-2118 |
| Mailing Address |
815 S Palafox St 3rd Flr Pensacola FL 32502-5937 |
| Practice Telephone | 9732511132 |
| Practice Fax Number | 5052875268 |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2019-12-05 |
| Authorized Official Name | KATHY KONDAS (OFFICER) |
| Authorized Official Telephone | 9732511132 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207P00000X | Emergency Medicine | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NM | 28477073 | 05 |
| Street Address |
1016 E ROOSEVELT AVE |
| City | GRANTS |
| State | NM |
| Zip Code | 87020-2118 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780677039 | Cibola General Hospital Corporation | General Acute Care Hospital | 1016 E Roosevelt Ave, Grants, NM 87020-2118 | 2005-08-23 |
| 1770047441 | Fedko Emergency Physicians New Mexico LLC | Emergency Medicine | 1016 E Roosevelt Ave, Grants, NM 87020-2118 | 2019-01-28 |
| 1023593472 | Megan Patricia Greteman | Physician Assistant | 1016 E Roosevelt Ave, Grants, NM 87020-2118 | 2018-10-02 |
| 1669954053 | Angela Marie Montgomery | Nurse Practitioner | 1016 E Roosevelt Ave, Grants, NM 87020-2118 | 2018-08-31 |
| 1558711846 | Alfredo Nevarez | Family Medicine | 1016 E Roosevelt Ave, Grants, NM 87020-2118 | 2016-06-16 |
| 1093024275 | Cibola General Hospital Phcy | Pharmacy | 1016 E Roosevelt Ave, Grants, NM 87020-2118 | 2010-10-05 |
| 1629122973 | Merton Olai Johnson | Nurse Anesthetist, Certified Registered | 1016 E Roosevelt Ave, Grants, NM 87020-2118 | 2007-01-23 |
| 1588694871 | Edward S. Sanshu Certified & Reg | Nurse Anesthetist, Certified Registered | 1016 E Roosevelt Ave, Grants, NM 87020-2118 | 2006-07-03 |
| 1134155443 | Edward S Sanshu | Nurse Anesthetist, Certified Registered | 1016 E Roosevelt Ave, Grants, NM 87020-2118 | 2006-06-26 |
| 1265489389 | Chander S Bhatia | Emergency Medicine | 1016 E Roosevelt Ave, Emergency Department, Grants, NM 87020-2118 | 2006-05-27 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104453836 | Tiffany Shell Flippen | Counselor | 1016 E. Roosevelt Ave., Grants, NM 87020 | 2020-03-24 |
| 1295382265 | Janell Marie Villalobos | Registered Nurse | 813 Mesa Blvd., Grants, NM 87020 | 2019-08-23 |
| 1396243390 | Las Brisas Enterprises, LLC | Clinic/Center | 1209 Bonita Ave Suite A, Grants, NM 87020 | 2018-01-25 |
| 1407386014 | Wilma Beverly White | Occupational Therapy Assistant | 200 Adams, Grants, NM 87020 | 2017-06-15 |
| 1063840551 | Patricia Thompson | Nurse Practitioner | 2111 Lobo Canyon Rd, Grants, NM 87020 | 2013-10-22 |
| 1063778512 | Adobe Foot and Ankle Specialists, P.C. | Podiatrist | 765 E. Roosevelt Ave., Grants, NM 87020 | 2012-04-10 |
| 1841588506 | Saint Mary Nonemergency Medical Transportatio | Non-emergency Medical Transport (VAN) | 1325 Saddlehorn Trail, Grants, NM 87020 | 2011-07-15 |
| 1801129416 | Tammy L. White | Social Worker | 2595 West Highway 66, Grants, NM 87020 | 2009-09-14 |
| 1720236524 | Martha Abeyta | Nurse Practitioner | 1210 Mt. Taylor Ave, Grants, NM 87020 | 2008-09-04 |
| 1780869255 | Lou G. Mazon-vigil | Homeopath | 1300 Del Norte Blvd, Grants, NM 87020 | 2008-01-03 |
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| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609826916 | Vista Emergency Physicians LLC | Emergency Medicine | 1015 E Roosevelt Ave, Emergency Department, Grants, NM 87020-2117 | 2006-05-10 |
| 1770047441 | Fedko Emergency Physicians New Mexico LLC | Emergency Medicine | 1016 E Roosevelt Ave, Grants, NM 87020-2118 | 2019-01-28 |
| 1265489389 | Chander S Bhatia | Emergency Medicine | 1016 E Roosevelt Ave, Emergency Department, Grants, NM 87020-2118 | 2006-05-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992261309 | Health West LLC | Emergency Medicine | 3300 W Main St Ste F, Artesia, NM 88210-9617 | 2019-02-11 |
| 1730612359 | Adam Michael Tolar | Emergency Medicine | Mcs 11 6025, 1 University of New Mexico, Albuquerque, NM 87131-0001 | 2017-04-10 |
| 1538691712 | David Scott Fischman | Emergency Medicine | 6400 Paseo Del Norte Blvd Ne, Albuquerque, NM 87113-8711 | 2017-03-28 |
| 1265895486 | Nedda Fariba Karimi | Emergency Medicine | 4515 Coors Blvd Nw, Albuquerque, NM 87120-3699 | 2016-04-04 |
| 1417310764 | Justin Itty Mathew | Emergency Medicine | Department of Emergency Medicine Msc11 6025, 1 University of New Mexico, Albuquerque, NM 87131-0001 | 2016-04-04 |
| 1639532583 | Amanda Lauren Ventura | Emergency Medicine | Msc Emergency Medicine 1 University of New Mexico, Albuquerque, NM 87131-2364 | 2016-03-29 |
| 1083000178 | David Michael Glass | Emergency Medicine | Emergency Medicine Msc 11 6025, University of New Mexico, Albuquerque, NM 87131-0001 | 2015-04-15 |
| 1952797300 | Eleni Marie Bucuvalas | Emergency Medicine | Msc 11-6025, 1 University of New Mexico, Albuquerque, NM 87131 | 2015-04-13 |
| 1225423239 | Joseph Smith Jr. | Emergency Medicine | Msc 11 6025 University of New Mexico, Albuquerque, NM 87131-0001 | 2015-04-06 |
| 1083026140 | Damek Santiago Maurice | Emergency Medicine | Christus St. Vincent Regional Medical Center, 455 St. Michaels Drive, Santa Fe, NM 87505 | 2014-05-23 |
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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.