University of New Mexico Medical Group, Inc.

Primary specialty

Student Health Clinic/CenterTaxonomy code 261QS1000X

License

88-PA05 Issued in NM

Legal business name

UNIVERSITY OF NEW MEXICO MEDICAL GROUP, INC.

Practice address

700 Louisiana SE
Albuquerque, NM 87108

Phone

(505) 256-2555

Fax

(505) 256-2555

NPI assigned

Jun 30, 2008

Organization subpart

No

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

Authorized official

Name

Mr. Anthony Masciotra

Title

Ceo

Phone

(505) 272-8950

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

University of New Mexico Medical Group Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• University of New Mexico Medical Group, Inc.

  • Student Health Clinic/Center
  • Tijeras, NM
  • NPI 1790946739
  NPD tax ID

Locations

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

{
    "created_epoch": "1214784000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214784000000",
    "number": "1043472111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "UNM SCHOOL BASED HEALTH CTRS",
            "address_2": "MSC09 1 UNIVERSITY OF NEW MEXICO",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871310001",
            "telephone_number": "502-720-4575",
            "fax_number": "505-272-2043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 LOUISIANA SE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "87108",
            "telephone_number": "505-256-2555",
            "fax_number": "505-256-2555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY OF NEW MEXICO MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-30",
        "last_updated": "2008-06-30",
        "status": "A",
        "authorized_official_last_name": "MASCIOTRA",
        "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": "88-PA05",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3A04",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• University of New Mexico Hospital-Bernalillo County Medical Center
• University of New Mexico Hospitals
• University of New Mexico Hospitals Asap
• University of New Mexico HSC
• University of New Mexico Medical Group Inc
• University of New Mexico Medical Group, Inc.
• University of New Mexico Medical Group, Inc.
• University of New Mexico Medical Group, Inc.
• University of New Mexico Medical Group, Inc.
• University of New Mexico Medical Group. Inc.

• All providers in Albuquerque, NM
• Student Health Clinic/Center in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 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.