Srirengam Muralidhasan MD LLC
Organization Active NPI Family Medicine Physician · Las Cruces, NM
NPI 1215929435 · NPPES record last updated Jan 12, 2021
Key facts
- NPI
- 1215929435
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- Legal business name
- SRIRENGAM MURALIDHASAN MD LLC
- Practice address
- 1605 El Paseo Rd
Las Cruces, NM 88001-6013 - Phone
- (575) 527-2600
- Fax
- (575) 527-5342
- NPI assigned
- Aug 16, 2005
- Reactivated
- Nov 10, 2020
- Organization subpart
- No
Authorized official
- Name
- Patricia Quintana
- Title
- Office Manager
- Phone
- (575) 405-7665
Practitioners 14
-
Monica Albidres, FNP-BC
-
Carmen Bernal, FNP-BC
-
Rhonda Willis Page, CNP
-
Amanda L Sollars, MD
-
Nellie Anastasia Thurston, DNP, FNP-BC
-
Eva Pavia Aguilar, FNP
-
Erin E Joslin-Gay, CNM
-
Judith Sarah Salazar, FNP
-
Maria De Jesus Martinez, FNP-C
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NM
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20050419001083 | NM | Part B Supplier - Clinic/Group Practice | 8123079274 |
Receives reassigned benefits from 12 practitioners Practice locations: Las Cruces, NM |
National Provider Directory
Locations
1605 El Paseo Rd
Las Cruces, NM 88001
Phone (505) 527-2600
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | Yes |
Addresses
Primary practice location
1605 El Paseo Rd
Las Cruces, NM 88001-6013
Mailing address
1605 El Paseo Rd
Las Cruces, NM 88001-6013
Phone (575) 405-7665
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| T6647 | Medicaid | NM |
Other providers in Las Cruces, NM
- Spinous Chiropractic Center, LLC
- Nancy M Spivey
- Madalyn Elyse Sprague
- Maranda Spurlin
- Pamela Sriharsha
- SSRR RX LLC
- Kaitlyn Stack
- Robert Michael Stack
- Ellen Ashley Stafford
- Jeanne Gail Stagner
All providers in Las Cruces, 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 Jan 12, 2021. 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.