Cleora Shunkamolah, M.D.

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

89-303 Issued in NM

Practice address

516 E Nizhoni Blvd
Gallup, NM 87301-5748

Phone

(505) 722-1000

NPI assigned

Mar 9, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in TX

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 1

Specialty

Family Practice

Education

University of New Mexico School of Medicine, 1987

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

DHHS,PHS,Naihs, Gallup Indian Medical CenterGroup PAC ID 3173436409, 179 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Gallup Indian Medical Center Hospital, Gallup, NM, CCN 320061

Merit-based Incentive Payment System (MIPS)

Final score

78.18 of 100Reported as group

Quality

61.12

Improvement activities

40

Cost

81.87

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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

• DHHS,PHS,Naihs, Gallup Indian Medical Center

  • General Acute Care Hospital
  • Gallup, NM
  • NPI 1225002322

  TX

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1141862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1482969600000",
    "number": "1073581583",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "516 E NIZHONI BLVD",
            "city": "GALLUP",
            "state": "NM",
            "postal_code": "873015748",
            "telephone_number": "505-722-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHUNKAMOLAH",
        "first_name": "CLEORA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-09",
        "last_updated": "2016-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NM",
            "license": "89-303",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "419475",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "R7335",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tanya Rae Shorty, RN
• Kara Shotwell, RN
• Kassandra Shouse, RN
• Juanita Shult
• Mindi Marie Shultz, RN
• William Henry Shunkamolah, PHD
• Leonora Shurley, RN
• Bernice E Sice, A.A.
• Monica Siclare, RN
• Jennifer Siess

• General Practice Physician in Gallup, NM
• Providers in Gallup, NM by specialty
• General Practice Physician in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.