Individual provider Active NPI

Roberto Thaddeus Araiza, M.D.

  • Pediatrics Physician
  • Santa Fe, NM
National Provider Identifier
1164583795
Registry record updated Oct 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD2010-0796 Issued in NM
Practice address
2025 Galisteo St
Santa Fe, NM 87505-2101
Phone
(505) 995-4901
Fax
(505) 989-6426
NPI assigned
Dec 13, 2006
Last updated
Oct 19, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2012

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 MD2010-0796 NM Primary

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

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20170322000753 TX Practitioner - Pediatric Medicine 4082710926 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
DHHS,PHS,Naihs, Gallup Indian Medical Center CurrentSince Nov 30, 2016 Accepting new patients
Harlem Medical Associates PC Past Accepting new patients
Trustees of Columbia University in the City of New York Pediatrics Past Accepting new patients

Locations

516 E Nizhoni Blvd
Gallup, NM 87301
Phone (505) 722-1326

Organizations & group practices 3

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": "1165968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350604800000",
    "number": "1164583795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2025 GALISTEO ST",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875052101",
            "telephone_number": "505-995-4901",
            "fax_number": "505-989-6426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2025 GALISTEO ST",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875052101",
            "telephone_number": "505-995-4901",
            "fax_number": "505-989-6426"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARAIZA",
        "first_name": "ROBERTO",
        "middle_name": "THADDEUS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-13",
        "last_updated": "2012-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NM",
            "license": "MD2010-0796",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Fe, NM

Sources for this page

Verify at the official NPI Registry.