Roberto Thaddeus Araiza, M.D.
Individual provider Active NPI Pediatrics Physician · Santa Fe, NM
NPI 1164583795 · NPPES record last updated Oct 19, 2012
Key facts
- NPI
- 1164583795
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatrics Physician 208000000X
- License
- MD2010-0796 (NM)
- Practice address
- 2025 Galisteo St
Santa Fe, NM 87505-2101 - Phone
- (505) 995-4901
- Fax
- (505) 989-6426
- NPI assigned
- Dec 13, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
- 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 |
|---|---|---|---|---|
| I20170322000753 | TX | Practitioner - Pediatric Medicine | 4082710926 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- No
- HHS exclusion list flag
- The National Provider Directory flags this NPI as appearing on an HHS exclusion list.
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| DHHS,PHS,Naihs, Gallup Indian Medical Center | Current |
Accepting new patients | |
| Trustees of Columbia University in the City of New York | Pediatrics | Past | Accepting new patients |
| Harlem Medical Associates PC | Past | Accepting new patients |
Locations
516 E Nizhoni Blvd
Gallup, NM 87301
Phone (505) 722-1326
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | MD2010-0796 | NM | Yes |
Addresses
Primary practice location
2025 Galisteo St
Santa Fe, NM 87505-2101
Mailing address
2025 Galisteo St
Santa Fe, NM 87505-2101
Phone (505) 995-4901
Other providers in Santa Fe, NM
- Kyanna L Aragon
- Michael Aragon
- Sarah Elizabeth Aragon
- Stephen Aragon
- Tracy Aragon
- Phillipa Jane Arbib
- Arc Physical Therapy, Sports and Rehab, LLC
- Sophia Archibald
- Jolene Archibeque
- Kamille Archie-Payne
All providers in Santa Fe, 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 Oct 19, 2012. 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.