Brian T Muniz, PAC
Individual provider Active NPI Physician Assistant · Santa Rosa, NM
NPI 1447760368 · NPPES record last updated Oct 5, 2017
Key facts
- NPI
- 1447760368
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- PA2017-0082 (NM)
- Practice address
- 117 Camino de Vida Ste 300
Santa Rosa, NM 88435-2267 - Phone
- (575) 472-4311
- Fax
- (575) 472-4313
- NPI assigned
- Oct 5, 2017
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 2
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- New Mexico Orthopaedic Associates PC
Practice addresses (Care Compare)
2101 Unser Blvd SE
Nmo Rio Rancho Clinic
Rio Rancho, NM 87124-6378
Phone (505) 724-4700
Hospital & facility affiliations
- Presbyterian Hospital
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: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20171127001655 | NM | Practitioner - Physician Assistant | 2668739806 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
Interoperability endpoints
- bmuniz220971@ahs.direct-ci.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA2017-0082 | NM | Yes |
Addresses
Primary practice location
117 Camino de Vida Ste 300
Santa Rosa, NM 88435-2267
Mailing address
117 Camino de Vida Ste 300
Santa Rosa, NM 88435-2267
Phone (575) 472-4311
Other providers in Santa Rosa, NM
- Martha J Miller
- Sonya Mireles
- Elizabeth A Montano
- Michael Montoya
- Nicole Montoya
- Vanessa Ortega
- Timothy William Overton
- Cara J Pacheco
- Carmen D Padilla
- Grace S Pedrick
All providers in Santa Rosa, NM · Physician Assistant 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 Oct 5, 2017. 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).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.