Emily Rothman, DO
Individual provider Active NPI Family Medicine Physician · Albuquerque, NM
NPI 1124119698 · NPPES record last updated Nov 7, 2019
Key facts
- NPI
- 1124119698
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- A-1176-01 (NM)
- Practice address
- 4710 Jefferson St NE
Albuquerque, NM 87109-2155 - Phone
- (505) 780-4040
- Fax
- (505) 888-9644
- NPI assigned
- Sep 27, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 21
Owned or controlled facilities with NPI records 4
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in NM, TX
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
All facility ownership & control disclosures 4
| Facility | Type | Role | Since |
|---|---|---|---|
| The Rehabilitation Center of Albuquerque |
Skilled nursing facility | Operational/Managerial Control Adp of the SNF |
Jun 1, 2024 Mar 12, 2025 |
| Canyon Transitional Rehabilitation Center |
Skilled nursing facility | Operational/Managerial Control Adp of the SNF |
Jun 1, 2024 Mar 10, 2025 |
| Bear Canyon Rehabilitation Center |
Skilled nursing facility | Operational/Managerial Control Adp of the SNF |
Jun 1, 2024 Feb 16, 2025 |
| Casa Real |
Skilled nursing facility | Operational/Managerial Control Adp of the SNF |
Jun 1, 2024 Jan 31, 2025 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100917000585 | NM | Practitioner - Family Practice | 9234037086 | Reassigns benefits to 4 organizations |
| I20171206002318 | TX | Practitioner - Family Practice | 9234037086 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pueblo of Jemez | Current |
Accepting new patients | |
| Canoncito Band of Navajos Health Center, Inc | Current | Accepting new patients | |
| Canoncito Band of Navajos Health Center, Inc. | Current |
Accepting new patients | |
| Alignmed Partners, PC | Current |
Accepting new patients | |
| Kewa Pueblo Health Corporation | Current |
Accepting new patients | |
| Alignmed Medical Group, PC | Current |
Accepting new patients | |
| Genesis Eldercare Physician Services LLC | Current |
Accepting new patients | |
| Genesis Eldercare Physician Services LLC | Current |
Accepting new patients | |
| Pueblo of Jemez | Current |
Accepting new patients | |
| Pueblo of Isleta | Past | Accepting new patients | |
| WW Healthcare LLC | Past | Accepting new patients | |
| The Rehabilitation Center of Albuquerque, LLC | Past | Accepting new patients | |
| 369 Albuquerque Ops LLC | Past | Accepting new patients | |
| Canyon Transitional Rehabilitation Center, LLC | Past | Accepting new patients | |
| Pueblo of Isleta | Past | Accepting new patients | |
| 1650 Galisteo Street Operations LLC | Past |
Accepting new patients | |
| PH Ops of Las Estancias LLC | Past | Accepting new patients | |
| Canoncito Band of Navajos Health Center, Inc. | Past |
Accepting new patients | |
| Pueblo of Isleta | Past | Accepting new patients | |
| Kewa Pueblo Health Corporation | Past | Accepting new patients |
Locations
5123 Juan Tabo Blvd NE
Albuquerque, NM 87111
Phone (505) 292-3333
10101 Lagrima de Oro Rd NE
Albuquerque, NM 87111
Phone (505) 298-1231
5900 Forest Hills Dr NE
Albuquerque, NM 87109
Phone (505) 514-2900
1831 Camino del Llano
Belen, NM 87002
Phone (505) 864-1600
85 W Highway 22
Santo Domingo Pueblo, NM 87052
Phone (505) 465-3060
129 Medicine Horse Dr
Tohajiilee, NM 87026
Phone (505) 908-2307
1660 Easton Rd
Warrington, PA 18976
Phone (215) 345-3205
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | A-1176-01 | NM | Yes |
Addresses
Primary practice location
4710 Jefferson St NE
Albuquerque, NM 87109-2155
Mailing address
PO Box 3338
Tohajiilee, NM 87026-3338
Phone (505) 908-2307
Other practice location 1
801 Encino Pl NE
suite C2
Albuquerque, NM 87102-2612
Phone (505) 242-7512
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 004A81 | Other | NM | BCBS FOR 850164038 |
| 85725064 | Medicaid | NM | |
| 004A55 | Other | NM | BCBS |
Other providers in Albuquerque, NM
- Robert K Rothberg
- Thomas Rothfeld
- Gail L Rothfork
- Jacob Melville Rothfork
- Colin Rothman
- Michael Louis Rothman
- Brian Rothrock
- Marisa Mancini Rothrock
- Nancy Rothschild
- Lauren Rotolo
All providers in Albuquerque, NM · Family Medicine 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 Nov 7, 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.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.