Individual provider Active NPI

Daniel Langsam, MD

  • Pediatrics Physician
  • Shiprock, NM
National Provider Identifier
1063679652
Registry record updated Jan 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD2017-0476 Issued in NM
Practice address
Hwy 491 N
Northern Navajo Medical Center
Shiprock, NM 87420
Phone
(505) 368-6001
NPI assigned
May 21, 2008
Last updated
Jan 24, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MD2017-0476 NM Primary

Addresses

Primary practice location

Hwy 491 N
Northern Navajo Medical Center
Shiprock, NM 87420

Mailing address

PO Box 160
Shiprock, NM 87420-0160
Phone (505) 368-6001

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
I20110124000362 TX Practitioner - Pediatric Medicine 4587843586 Reassigns benefits to 3 organizations
I20190524001691 NM Practitioner - Pediatric Medicine 4587843586 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Pueblo of Isleta CurrentSince Apr 6, 2019 Accepting new patients
Pueblo of Isleta CurrentSince Apr 6, 2019 Accepting new patients
DHHS, PHS, Naihs, Shiprock Hospital CurrentSince Dec 13, 2010 Accepting new patients
Santa Ana Health Center CurrentSince Feb 2, 2020 Accepting new patients
Albuquerque Indian Health Center CurrentSince Feb 2, 2020 Accepting new patients
DHHS, PHS, Naihs, Shiprock Hospital CurrentSince Dec 13, 2010 Accepting new patients
Pueblo of Isleta Past Accepting new patients
Pueblo of Isleta Past Accepting new patients

Locations

1 Sagebrush St SW
Albuquerque, NM 87105
Phone (505) 869-4463

801 Vassar Dr NE
Albuquerque, NM 87106
Phone (505) 248-4000

2 Dove Rd
#C
Bernalillo, NM 87004
Phone (505) 867-2497

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1211328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548288000000",
    "number": "1063679652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 160",
            "city": "SHIPROCK",
            "state": "NM",
            "postal_code": "874200160",
            "telephone_number": "505-368-6001",
            "fax_number": "505-368-7011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "HWY 491 N",
            "address_2": "NORTHERN NAVAJO MEDICAL CENTER",
            "city": "SHIPROCK",
            "state": "NM",
            "postal_code": "87420",
            "telephone_number": "505-368-6001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANGSAM",
        "first_name": "DANIEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-05-21",
        "last_updated": "2019-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NM",
            "license": "MD2017-0476",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shiprock, NM

Sources for this page

Verify at the official NPI Registry.