Michael W Gavin, MD

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

93-60 Issued in NM

Practice address

1001 Dr Martin Luther King Jr Ave NE
Albuquerque, NM 87106-4713

Phone

(505) 272-4755

Fax

(505) 272-6839

NPI assigned

Jul 11, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NM

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Unm Medical Group Inc

  • Multi-Specialty Clinic/Center
  • Albuquerque, NM
  • NPI 1831218627
  Medicare reassignment NPD
• Unm Medical Group, Inc.

  • Community/Retail Pharmacy
  • Albuquerque, NM
  • NPI 1417330044
  NPD

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

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339027200000",
    "number": "1255365391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 DR MARTIN LUTHER KING JR AVE NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871064713",
            "telephone_number": "505-272-4755",
            "fax_number": "505-272-6839"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 DR MARTIN LUTHER KING JR AVE NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871064713",
            "telephone_number": "505-272-4755",
            "fax_number": "505-272-6839"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAVIN",
        "first_name": "MICHAEL",
        "middle_name": "W",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-11",
        "last_updated": "2012-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NM",
            "license": "93-60",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4456",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christopher Gavaldon, PA-C
• Dominic Gavi
• Roger Louis Gavi, RN
• Camille Gavin
• Katherine J Gavin, M.D.
• Chakri Gavva, M.D.
• Monika Gawne, CSW
• Gay L Gustafson DPM PC
• Gay Pasley Enterprises
• Louise Gaylor

• Gastroenterology Physician in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Gastroenterology Physician in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.