Vanessa D Licona Sanjuan, MD

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

MD2012-0867 Issued in NM

Practice address

500 Walter St NE
Ste 401
Albuquerque, NM 87102-2563

Phone

(505) 727-5910

Fax

(505) 727-5939

NPI assigned

Jul 26, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

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

Specialty

Neurology

Education

Other, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Southwest Medical Associates, LLCGroup PAC ID 7214831114, 326 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Lovelace Medical Center Hospital, Albuquerque, NM, CCN 320009
• Lovelace Women'S Hospital Hospital, Albuquerque, NM, CCN 320017
• Lovelace Westside Hospital Hospital, Albuquerque, NM, CCN 320074
• Lovelace Unm Rehabilitation Hospital Inpatient rehabilitation facility, Albuquerque, NM, CCN 323028

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: vliconasanjuan9126@ahs.direct-ci.com

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.

• Southwest Medical Associates, LLC

  • General Practice Physician
  • Albuquerque, NM
  • NPI 1164491072
  Medicare reassignment Care Compare group NPD
• Southwest Medical Associates, LLC

  • Rural Health Clinic/Center
  • Roswell, NM
  • NPI 1578255253
  NPD

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

• Lovelace Health System LLC

  • General Acute Care Hospital
  • Albuquerque, NM
  • NPI 1306914213
  Care Compare affiliation
• Lovelace Health System, LLC

  • General Acute Care Hospital
  • Albuquerque, NM
  • NPI 1649373887
  Care Compare affiliation
• Lovelace Health System, LLC

  • General Acute Care Hospital
  • Albuquerque, NM
  • NPI 1982799375
  Care Compare affiliation
• Lovelace Unm Rehabilitation Hospital LLC

  • Rehabilitation Hospital
  • Albuquerque, NM
  • NPI 1700325677

  Inpatient rehabilitation facility

  Care Compare affiliation

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

{
    "created_epoch": "1280102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1492560000000",
    "number": "1386958825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 WALTER ST NE",
            "address_2": "STE 401",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871022563",
            "telephone_number": "505-727-5910",
            "fax_number": "505-727-5939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 WALTER ST NE",
            "address_2": "STE 401",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871022563",
            "telephone_number": "505-727-5910",
            "fax_number": "505-727-5939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LICONA SANJUAN",
        "first_name": "VANESSA",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-26",
        "last_updated": "2017-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NM",
            "license": "MD2012-0867",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "98305522",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rosanne Marie Licata, LPC
• Annette J Licht, RN
• Kristin Lichtle, LPCC
• Abraham Lichtmacher, MD
• Heather Rosa Licini
• Jonas Lieb
• Lyndon L. Liebelt, D.D.S.
• Vicki Theresa Lieber-Spiess, LCSW
• Margaret Lieberman, MD
• Anne Liechty

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2017; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.