Active NPI
Mauro S Nava, R.T.
- Radiologic Technologist
- Albuquerque, NM
National Provider Identifier
1447553607
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Radiologic Technologist
- License
- 152381
- Practice address
- 1804 June St NE
Albuquerque, NM 87112-3146 - Phone
- (505) 843-9836
- Fax
- (505) 332-9825
- NPI assigned
- Dec 9, 2010
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Radiologic Technologist | 247100000X | 152381 | NM | Primary |
Addresses
Primary practice location
1804 June St NE
Albuquerque, NM 87112-3146
Mailing address
1804 June St NE
Albuquerque, NM 87112-3146
Phone (505) 843-9836
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 152381 | NM | MD | Radiologic Technologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Omni Medical Group LLC | Current | Accepting new patients |
Organizations & group practices 1
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.
-
- Clinic/Center
- Albuquerque, NM
- NPI 1568768042
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1291852800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1291852800000",
"number": "1447553607",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1804 JUNE ST NE",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871123146",
"telephone_number": "505-843-9836",
"fax_number": "505-332-9825"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1804 JUNE ST NE",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871123146",
"telephone_number": "505-843-9836",
"fax_number": "505-332-9825"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NAVA",
"first_name": "MAURO",
"middle_name": "S",
"name_prefix": "Mr.",
"credential": "R.T.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-12-09",
"last_updated": "2010-12-09",
"status": "A"
},
"taxonomies": [
{
"code": "247100000X",
"taxonomy_group": "",
"desc": "Radiologic Technologist",
"state": "NM",
"license": "152381",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Albuquerque, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.