Individual provider Active NPI

Walter Felipe Zanghellini, MD

  • Pediatrics Physician
  • Albuquerque, NM
National Provider Identifier
1205919867
Registry record updated Jan 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
98206 Issued in NM
Practice address
4420 Irving Blvd NW
Albuquerque, NM 87114-5915
Phone
(505) 727-6300
Fax
(505) 727-9588
NPI assigned
Oct 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2020

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 98206 NM Primary

Addresses

Primary practice location

4420 Irving Blvd NW
Albuquerque, NM 87114-5915

Mailing address

4420 Irving Blvd NW
Albuquerque, NM 87114-5915
Phone (505) 727-6300

Other identifiers 1

IdentifierTypeStateIssuer
T6729MedicaidNM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
98206NMMDPediatrics Physician

NPI Registry JSON

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

{
    "created_epoch": "1161648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1577923200000",
    "number": "1205919867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4420 IRVING BLVD NW",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871145915",
            "telephone_number": "505-727-6300",
            "fax_number": "505-727-9588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4420 IRVING BLVD NW",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871145915",
            "telephone_number": "505-727-6300",
            "fax_number": "505-727-9588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZANGHELLINI",
        "first_name": "WALTER",
        "middle_name": "FELIPE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-24",
        "last_updated": "2020-01-02",
        "certification_date": "2020-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NM",
            "license": "98206",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "T6729",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.