MANIDEEP GOTUR (NPI# 1710384581) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710384581 |
| Entity Type | Individual |
| Full Name | MANIDEEP GOTUR |
| Credential | MD |
| Practice Address |
4005 High Resort Blvd Se Rio Rancho NM 87124-5906 |
| Mailing Address |
Po Box 26666 Phs Provider Enrollment Albuquerque NM 87125-6666 |
| Practice Telephone | 5054626000 |
| Enumeration Date | 2014-11-21 |
| Last Update Date | 2016-06-27 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | MD2016-0014 | NM | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Street Address |
4005 HIGH RESORT BLVD SE |
| City | RIO RANCHO |
| State | NM |
| Zip Code | 87124-5906 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992701759 | Doris Kay Gonzales | Nurse Practitioner | 4005 High Resort Blvd Se, Pmg Rio Rancho High Resort 4005, Rio Rancho, NM 87124-5906 | 2005-06-24 |
| 1770149395 | Kristyn Bilak | Registered Nurse | 4005 High Resort Blvd Se, Rio Rancho, NM 87124-5906 | 2019-05-20 |
| 1770067167 | Jacqueline S Guinn | Family Medicine | 4005 High Resort Blvd Se, Rio Rancho, NM 87124-5906 | 2018-09-20 |
| 1073033650 | David Allen Zarikta | Nurse Practitioner | 4005 High Resort Blvd Se, Rio Rancho, NM 87124-5906 | 2017-06-23 |
| 1720538390 | Ludmila Zlatkin | Nurse Practitioner | 4005 High Resort Blvd Se, Rio Rancho, NM 87124-5906 | 2016-10-07 |
| 1144774712 | Ebubechukwu Njemanze | Internal Medicine | 4005 High Resort Blvd Se, Rio Rancho, NM 87124-5906 | 2016-08-11 |
| 1578016994 | Erin Nicole Etzel | Psychologist | 4005 High Resort Blvd Se, Rio Rancho, NM 87124-5906 | 2016-08-02 |
| 1467801399 | Simone Green | Pediatrics | 4005 High Resort Blvd Se, Rio Rancho, NM 87124-5906 | 2016-06-10 |
| 1003275959 | Shae Ray | Registered Nurse | 4005 High Resort Blvd Se, Rio Rancho, NM 87124-5906 | 2016-02-21 |
| 1801252895 | Julio Cesar Hernandez Roman | Physician Assistant | 4005 High Resort Blvd Se, Rio Rancho, NM 87124-5906 | 2016-01-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740895648 | Dallon Knight | Pharmacist | 1115 Nm-528 Se, Rio Rancho, NM 87124 | 2020-09-09 |
| 1447875133 | Paul D Phillip | Counselor | 1207 Golf Course Rd Ne, Suite C, Rio Rancho, NM 87124 | 2020-06-09 |
| 1093341810 | Clearsky Rehabilitation Hospital of Rio Rancho LLC | Rehabilitation Hospital | 2401 Westside Blvd, Rio Rancho, NM 87124 | 2020-03-13 |
| 1841840345 | Debra English | Technician | 2001 Yucca St Se, Rio Rancho, NM 87124 | 2019-09-17 |
| 1114589322 | Counseling Connections, LLC | Counselor | 2600 Istle Rd Ne, Rio Rancho, NM 87124 | 2019-07-08 |
| 1417414996 | Kimberly Lovette Lorenzini | Counselor | Rio Rancho Family Counseling, 1340 Monterrey Rd, Rio Rancho, NM 87124 | 2019-02-21 |
| 1225507197 | Speech and Language Possibilities, LLC | Audiologist | 273 Tigris Road Ne, Rio Rancho, NM 87124 | 2018-11-20 |
| 1063997823 | Cindy Pendrey, LLC | Clinic/Center | 2103 Golf Course Rd Se, Suite A, Rio Rancho, NM 87124 | 2018-09-27 |
| 1972094324 | Calmar Inc. | Durable Medical Equipment & Medical Supplies | 2003 Southern Blvd Ne, Suite 123, Rio Rancho, NM 87124 | 2018-05-22 |
| 1013404581 | New Mexico Dental Clinics LLC | Dentist | 1594 Sara Rd Se Ste C, Rio Rancho, NM 87124 | 2018-04-19 |
| Find all providers in zip 87124 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609141076 | Christina M Haaland | Internal Medicine | 1009 Golf Course Rd Se Ste 109, Rio Rancho, NM 87124 | 2012-03-18 |
| 1700934833 | Stephen Anthony Vaughn | Internal Medicine | 1760 Grande Boulevard Se, Rio Rancho, NM 87124 | 2007-01-08 |
| 1548331499 | Eugene F. Sun | Internal Medicine | 2300 Grande Blvd Se, Rio Rancho, NM 87124-1755 | 2006-11-13 |
| 1598733859 | Naishadh Ajitrai Mankad | Internal Medicine | 184 Unser Blvd Ne, Rio Rancho, NM 87124 | 2006-03-10 |
| 1194717801 | Robert Anthony Gardner | Internal Medicine | 2410 19th St Se, Rio Rancho, NM 87124-4857 | 2005-08-18 |
| 1891342994 | Center for Vein Restoration Nm LLC | Internal Medicine | 1790 Grande Blvd Se, Rio Rancho, NM 87124-1756 | 2019-08-22 |
| 1376022822 | Hospitalist Medicine Physicians of New Mexico -tcg LLC | Internal Medicine | 2400 Unser Blvd Se, Rio Rancho, NM 87124-4740 | 2018-08-07 |
| 1144774712 | Ebubechukwu Njemanze | Internal Medicine | 4005 High Resort Blvd Se, Rio Rancho, NM 87124-5906 | 2016-08-11 |
| 1629464862 | Mathew Theodore Ley | Internal Medicine | 3001 Broadmoor Blvd Ne, Rio Rancho, NM 87144-2100 | 2015-04-14 |
| 1033522685 | Azharuddin Mohammed Akbar Soudagar | Internal Medicine | 2400 Unser Blvd Se, Rio Rancho, NM 87124 | 2014-06-10 |
| Find all providers in RIO RANCHO | ||||
| City | RIO RANCHO |
| Zip Code | 87124 |
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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.