Individual provider Active NPI

Juan Pablo Rossini, MD

  • Anesthesiology Physician
  • Gallup, NM
National Provider Identifier
1013184654
Registry record updated Mar 24, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
59969-20 Issued in WI
Practice address
516 East Nizhoni Blvd.
Gallup, NM 87301-1337
Phone
(505) 722-1000
Fax
(505) 722-1421
NPI assigned
May 13, 2008
Last updated
Mar 24, 2014By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 24, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Anesthesiology Physician 207L00000X 59969-20 WI Primary

Addresses

Primary practice location

516 East Nizhoni Blvd.
Gallup, NM 87301-1337

Mailing address

PO Box 1337
Gallup, NM 87305-1337
Phone (505) 722-1000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, NM2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20140403000797 TX Practitioner - Anesthesiology 9638300726 Reassigns benefits to 1 organization
I20250827003907 NM Practitioner - Anesthesiology 9638300726 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Main Street Anesthesia of New Mexico, LLCGroup PAC ID 3476807538, 228 clinicians
Carlsbad Anesthesia Services LLCGroup PAC ID 2365696960, 10 clinicians

Practice addresses (Care Compare)

117 E 19TH St
Lovelace Regional Hospital Roswell
Roswell, NM 88201-5151
Phone (575) 627-7000

2430 W Pierce St
Carlsbad, NM 88220-3553
Phone (575) 887-4100

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
59969-20WIMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
DHHS,PHS,Naihs, Gallup Indian Medical Center CurrentSince Feb 15, 2014 Accepting new patients
Main Street Anesthesia of New Mexico, LLC Anesthesiology CurrentSince Jul 1, 2025 Accepting new patients

Locations

2430 W Pierce St
Carlsbad, NM 88220
Phone (505) 887-4100

516 E Nizhoni Blvd
Gallup, NM 87301
Phone (505) 722-1326

117 E 19th St
Roswell, NM 88201
Phone (505) 727-2000

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1210636800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395619200000",
    "number": "1013184654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1337",
            "city": "GALLUP",
            "state": "NM",
            "postal_code": "873051337",
            "telephone_number": "505-722-1000",
            "fax_number": "505-722-1421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "516 EAST NIZHONI BLVD.",
            "city": "GALLUP",
            "state": "NM",
            "postal_code": "873011337",
            "telephone_number": "505-722-1000",
            "fax_number": "505-722-1421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSSINI",
        "first_name": "JUAN",
        "middle_name": "PABLO",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-05-13",
        "last_updated": "2014-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "WI",
            "license": "59969-20",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gallup, NM

Sources for this page

Verify at the official NPI Registry.