NPIMap

Organization Active NPI

University of New Mexico

  • Student Health Clinic/Center
  • Albuquerque, NM
National Provider Identifier
1043461163
Registry record updated Oct 7, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student Health Clinic/CenterTaxonomy code 261QS1000X
License
R45196 Issued in NM
Legal business name
UNIVERSITY OF NEW MEXICO
Practice address
1111 Easterday Dr NE
Albuquerque, NM 87112-5115
Phone
(505) 299-2113
Fax
(505) 323-1338
NPI assigned
Oct 7, 2008
Last updated
Oct 7, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2008

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

Authorized official

Name
Mr. Anthony Masciatra
Title
Ceo
Phone
(505) 272-8950

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student Health Clinic/Center 261QS1000X R45196 NM Primary

Addresses

Primary practice location

1111 Easterday Dr NE
Albuquerque, NM 87112-5115

Mailing address

Unm School Based Health CTRS
Msc09 5040 1 University of New Mexico
Albuquerque, NM 87131-0001
Phone (505) 272-0457

Other identifiers 1

IdentifierTypeStateIssuer
3A12MedicaidNM

National Provider Directory

National Provider Directory
Tax ID family
University of New Mexico Dental Services17 organizations share this tax ID, including this one

Other organizations with this tax ID 16

Organizations that report the same tax identification number in the National Provider Directory.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1223337600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1223337600000",
    "number": "1043461163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "UNM SCHOOL BASED HEALTH CTRS",
            "address_2": "MSC09 5040 1 UNIVERSITY OF NEW MEXICO",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871310001",
            "telephone_number": "505-272-0457",
            "fax_number": "505-272-2043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 EASTERDAY DR NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871125115",
            "telephone_number": "505-299-2113",
            "fax_number": "505-323-1338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY OF NEW MEXICO",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-07",
        "last_updated": "2008-10-07",
        "status": "A",
        "authorized_official_last_name": "MASCIATRA",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "505-272-8950",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QS1000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Student Health",
            "state": "NM",
            "license": "R45196",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3A12",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.