NPIMap

Individual provider Active NPI

Jan A Gotta, M.D.

  • Anesthesiology Physician
  • Farmington, NM
National Provider Identifier
1265405302
Registry record updated Dec 10, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
MD2004-0691 Issued in NM
Practice address
801 W Maple St
Farmington, NM 87401-5630
Phone
(505) 326-6400
Fax
(505) 326-4606
NPI assigned
Feb 9, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X MD2004-0691 NM Primary

Addresses

Primary practice location

801 W Maple St
Farmington, NM 87401-5630

Mailing address

1515 E 20TH St
Suite a
Farmington, NM 87401-9039
Phone (505) 326-6400

Other identifiers 8

IdentifierTypeStateIssuer
201050016OtherNMPRESBYTERIAN HP
73670375MedicaidCO
927494MedicaidAZ
10016519OtherNMLOVELACE
NM009T46OtherNMBCBS
77636554MedicaidNM
T0364MedicaidUT
P00201833OtherNMRR MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM, TX2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20050405000031 NM Practitioner - AnesthesiologyPractitioner - Interventional Pain Management 1759333842 Reassigns benefits to 1 organization
I20150206001603 TX Practitioner - AnesthesiologyPractitioner - Pain Management 1759333842 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
AnesthesiologyAlso: Pain Management
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
BHS Physicians Network, IncGroup PAC ID 7315019593, 702 clinicians

Practice addresses (Care Compare)

2930 N Stanton St
El Paso, TX 79902-2511
Phone (915) 271-4569

Hospital & facility affiliations

  • The Hospitals of Providence - East Campus Hospital, El Paso, TX, CCN 670047

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
BHS Physicians Network, Inc CurrentSince Jun 1, 2023 Accepting new patients
Anesthesia Associates of New Mexico P C CurrentSince Mar 30, 2015 Accepting new patients
BHS Physicians Network, Inc CurrentSince Jun 1, 2023 Accepting new patients
Springfield Anesthesia Service, Inc. Anesthesiology Past Accepting new patients
BHS Specialty Network Inc Past Accepting new patients
San Juan Regional Medical Center Inc Past Accepting new patients
Umass Memorial Medical Group Inc Anesthesiology Past Accepting new patients

Locations

1720 Louisiana Blvd NE
Ste 401
Albuquerque, NM 87110
Phone (505) 260-4300

1100 Central Ave SE
Albuquerque, NM 87106
Phone (505) 724-6124

8300 Constitution Ave NE
Albuquerque, NM 87110
Phone (505) 291-2000

1755 Curie Dr
Ste A
El Paso, TX 79902
Phone (915) 534-1329

2930 N Stanton St
El Paso, TX 79902
Phone (915) 271-4569

3903 Wiseman Blvd
Ste 100
San Antonio, TX 78251
Phone (210) 681-0126

3903 Wiseman Blvd
San Antonio, TX 78251
Phone (210) 681-0126

Organizations & group practices 22

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.

View all 22

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1139443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1260403200000",
    "number": "1265405302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1515 E 20TH ST",
            "address_2": "SUITE A",
            "city": "FARMINGTON",
            "state": "NM",
            "postal_code": "874019039",
            "telephone_number": "505-326-6400",
            "fax_number": "505-326-4606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 W MAPLE ST",
            "city": "FARMINGTON",
            "state": "NM",
            "postal_code": "874015630",
            "telephone_number": "505-326-6400",
            "fax_number": "505-326-4606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOTTA",
        "first_name": "JAN",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-09",
        "last_updated": "2009-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NM",
            "license": "MD2004-0691",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRESBYTERIAN HP",
            "identifier": "201050016",
            "state": "NM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "73670375",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "927494",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LOVELACE",
            "identifier": "10016519",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "NM009T46",
            "state": "NM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "77636554",
            "state": "NM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "T0364",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00201833",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmington, NM

Sources for this page

Verify at the official NPI Registry.