Mary Therese Cunnane, M.D.

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

88-149 Issued in NM

Practice address

4640 Jefferson LN NE
Albuquerque, NM 87109-2127

Phone

(505) 843-6168

Fax

(505) 792-1978

NPI assigned

Apr 7, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 6

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: mcunnane7571@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.

• Alegent Creighton Clinic

  • Family Medicine Physician
  • Council Bluffs, IA
  • NPI 1598811069
  NPD (past)

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

{
    "created_epoch": "1144368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594771200000",
    "number": "1518920099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6320 RIVERSIDE PLAZA LN NW STE B",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871201710",
            "telephone_number": "505-843-6168",
            "fax_number": "505-792-1978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4640 JEFFERSON LN NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871092127",
            "telephone_number": "505-843-6168",
            "fax_number": "505-792-1978"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUNNANE",
        "first_name": "MARY",
        "middle_name": "THERESE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-07",
        "last_updated": "2020-07-15",
        "certification_date": "2020-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NE",
            "license": "24905",
            "primary": false
        },
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "NY",
            "license": "147803-1",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NM",
            "license": "88-149",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS OF WESTERN NEW YORK",
            "identifier": "000927695002",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00008169",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CHOICE",
            "identifier": "P010147803",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5362090",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED CARE",
            "identifier": "171575CK",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD",
            "identifier": "P00265970",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tiffany Angelic Cummings, LCSW
• Martha Carroll Cummins-Bell, LMSW
• Laura Cummins
• Cecilia Rebecca Cuneo
• Juliette M Cunico, SLP
• Rachael A Cunnick, PA-C
• Marisa Gwen Cunningham Cameron
• Alicia E Cunningham, DPT
• Amy Cunningham, BSN, RN
• Amy Cunningham, MD

• Obstetrics & Gynecology Physician in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Obstetrics & Gynecology Physician in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.