Carlos J Esparza MD PC

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

97227 Issued in NM

Legal business name

CARLOS J ESPARZA MD PC

Practice address

3846 Masthead St NE
Albuquerque, NM 87109-4479

Phone

(505) 242-1711

Fax

(505) 242-0189

NPI assigned

Jul 16, 2006

Organization subpart

No

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

Authorized official

Name

Lori Montanez

Title

Chief Admin Officer

Phone

(505) 938-1517

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NM

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Carlos J Esparza, MD

  • Physical Medicine & Rehabilitation Physician
  • Albuquerque, NM
  • NPI 1255399630

  NM, Physical Medicine & Rehabilitation

  Medicare reassignment Care Compare group NPD
• Sean Portman, PA

  • Medical Physician Assistant
  • Albuquerque, NM
  • NPI 1245788603

  NM

  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1153008000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1392076800000",
    "number": "1366469314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3846 MASTHEAD ST NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871094479",
            "telephone_number": "505-242-1711",
            "fax_number": "505-242-0189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3846 MASTHEAD ST NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871094479",
            "telephone_number": "505-242-1711",
            "fax_number": "505-242-0189"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARLOS J ESPARZA MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-16",
        "last_updated": "2014-02-11",
        "status": "A",
        "authorized_official_last_name": "MONTANEZ",
        "authorized_official_first_name": "LORI",
        "authorized_official_title_or_position": "CHIEF ADMIN OFFICER",
        "authorized_official_telephone_number": "505-938-1517"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NM",
            "license": "97227",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000Q28004",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Aaron Hugh Carlisle, RPH
• Jacqueline Carlisle, D.C.
• Lisbeth Jane Carlisle, RN
• Lorraine M Carlisle, R.PH.
• Sally Carlon, LPCC
• Mikki Carlow, L.M.S.W
• Breeanna Carlson, DO
• Cristina Carlson, CNS
• David A Carlson, CRNA
• Elizabeth Mary Carlson, CNM, FNP

• All providers in Albuquerque, NM
• Physical Medicine & Rehabilitation Physician in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.