Basil A Anaele, MD
Individual provider Active NPI Pediatrics Physician · Clovis, NM
NPI 1437403813 · NPPES record last updated Nov 6, 2012
Key facts
- NPI
- 1437403813
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatrics Physician 208000000X
- License
- MD2012-0726 (NM)
- Practice address
- 1521 W 13TH St
Clovis, NM 88101-5568 - Phone
- (575) 769-0888
- Fax
- (575) 763-9154
- NPI assigned
- Nov 6, 2012
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 8
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NM
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20130126000006 | NM | Practitioner - Pediatric Medicine | 7315191475 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD2012-0726 | NM | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Roosevelt County Special Hospital District | Current |
Accepting new patients | |
| Roswell Clinic Corp | Current |
Accepting new patients | |
| Presbyterian Healthcare Services | Current |
Accepting new patients | |
| Presbyterian Healthcare Services | Pediatrics | Current |
Accepting new patients |
| Roswell Clinic Corp | Current |
Accepting new patients | |
| Roosevelt County Special Hospital District | Current |
Accepting new patients | |
| Roosevelt County Special Hospital District | Past | Accepting new patients | |
| Roswell Hospital Corporation | Past | Accepting new patients |
Locations
2000 W 21st St
Ste R1
Clovis, NM 88101
Phone (505) 763-3445
2200 W 21st St
Clovis, NM 88101
Phone (505) 769-7577
42121 US Highway 70
Portales, NM 88130
Phone (505) 226-3627
405 W Country Club Rd
Roswell, NM 88201
Phone (505) 622-8170
601 W Country Club Rd
Ste 101
Roswell, NM 88201
Phone (575) 622-8170
Interoperability endpoints
- basilanaele@rghnm.medalliesdirect.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | MD2012-0726 | NM | Yes |
Addresses
Primary practice location
1521 W 13TH St
Clovis, NM 88101-5568
Mailing address
1515 W Fir St
Portales, NM 88130-5703
Phone (575) 356-6695
Other providers in Clovis, NM
- Naomi Lynn Amador
- Amarillo Vamc
- Maria Dolores Amaro
- Jacqueline Nicole Ambrus
- American Arthritis & Rheumatology Associates - NM LLC
- Charlene Anaele
- Ronda Renee Anaya
- Sarah Elizabeth Anderson
- Ivone Andrade
- Kynadie Andrews
All providers in Clovis, NM · Pediatrics 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 Nov 6, 2012. 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.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.