Daniel Langsam, MD
Individual provider Active NPI Pediatrics Physician · Shiprock, NM
NPI 1063679652 · NPPES record last updated Jan 24, 2019
Key facts
- NPI
- 1063679652
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatrics Physician 208000000X
- License
- MD2017-0476 (NM)
- Practice address
- Hwy 491 N
Northern Navajo Medical Center
Shiprock, NM 87420 - Phone
- (505) 368-6001
- NPI assigned
- May 21, 2008
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 8
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in TX, NM
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pueblo of Isleta | Current |
Accepting new patients | |
| Albuquerque Indian Health Center | Current |
Accepting new patients | |
| Santa Ana Health Center | Current |
Accepting new patients | |
| DHHS, PHS, Naihs, Shiprock Hospital | Current |
Accepting new patients | |
| DHHS, PHS, Naihs, Shiprock Hospital | Current |
Accepting new patients | |
| Pueblo of Isleta | Current |
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
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | MD2017-0476 | NM | Yes |
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
Other providers in Shiprock, NM
- Cameron Thomas Lachappelle
- Carolyn J. Laitsch
- Melvina Lake
- Sydney Reed Lambert
- Joann Lameman
- Sonia Lansing-Gleason
- Rosa A. Largo
- Lori Larochelle
- William Raymond Larrick
- Heidi E. Larson
All providers in Shiprock, NM · Pediatrics Physician in New Mexico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 24, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.