Alan Mannheimer, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

2003-0483 Issued in NM

Practice address

407 S Schwartz Ave Ste 201
Farmington, NM 87401-5925

Phone

(505) 609-6700

Fax

(505) 609-2259

NPI assigned

Apr 21, 2009

Sex

Male

Sole proprietor

No

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

Specialties & licenses 5

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in NM, FL2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Taos Health Systems Inc Holy Cross Hospital

  • General Acute Care Hospital
  • Taos, NM
  • NPI 1194751958
  Medicare reassignment NPD
• Taos Professional Services,LLC

  • Surgery Physician
  • Taos, NM
  • NPI 1891070777
  Medicare reassignment NPD
• Halifax Healthcare Systems Inc

  • Family Medicine Physician
  • Daytona Beach, FL
  • NPI 1245283530
  Medicare reassignment NPD
• Taos Professional Services, LLC

  • General Practice Physician
  • Taos, NM
  • NPI 1235597964
  NPD
• Cfvhs Ed Physicians

  • Emergency Medicine Physician
  • Fayetteville, NC
  • NPI 1215931589
  NPD
• Cfvhs Ed Physicians

  • Emergency Medicine Physician
  • Raeford, NC
  • NPI 1790183184
  NPD
• Mercy Medical Center

  • Psychiatry Physician
  • Williston, ND
  • NPI 1801928593
  NPD
• San Juan Regional Medical Center, Inc.

  • General Acute Care Hospital
  • Farmington, NM
  • NPI 1427058510
  NPD (past)
• Taos Health Systems, Inc., Holy Cross Hospital

  • Critical Access Hospital
  • Taos, NM
  • NPI 1902338049
  NPD (past)
• Cumberland River Hospital Inc

  • Family Medicine Physician
  • Celina, TN
  • NPI 1558676445
  NPD (past)
• RCHP-Sierra Vista Inc

  • General Acute Care Hospital
  • Sierra Vista, AZ
  • NPI 1194766543
  NPD (past)
• Sierra Vista Regional Health Center Medical Group LLC

  • Family Medicine Physician
  • Sierra Vista, AZ
  • NPI 1043575483

  Pediatrics

  NPD (past)

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

{
    "created_epoch": "1240272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730246400000",
    "number": "1679717789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 QUAIL TRAIL",
            "address_2": "UNIT B",
            "city": "EDGEWOOD",
            "state": "NM",
            "postal_code": "87015",
            "telephone_number": "505-208-0204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "407 S SCHWARTZ AVE STE 201",
            "city": "FARMINGTON",
            "state": "NM",
            "postal_code": "874015925",
            "telephone_number": "505-609-6700",
            "fax_number": "505-609-2259"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11601 Montgomery Blvd NE",
            "address_purpose": "LOCATION",
            "city": "Albuquerque",
            "state": "NM",
            "postal_code": "871112660",
            "country_code": "US",
            "telephone_number": "555-555-5555",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3300 Gallows Rd",
            "address_purpose": "LOCATION",
            "city": "Falls Church",
            "state": "VA",
            "postal_code": "220423307",
            "country_code": "US",
            "telephone_number": "703-776-4001",
            "fax_number": "703-776-7113",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "104 Quail Trail",
            "address_2": "Unit B",
            "address_purpose": "LOCATION",
            "city": "Edgewood",
            "state": "NM",
            "postal_code": "87015",
            "country_code": "US",
            "telephone_number": "505-208-0204",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MANNHEIMER",
        "first_name": "ALAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-04-21",
        "last_updated": "2024-10-30",
        "certification_date": "2024-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "FL",
            "license": "ME114820",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NM",
            "license": "2003-0483",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "VA",
            "license": "0101277209",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "2013-00527",
            "primary": false
        },
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "CA",
            "license": "A95367",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "007868100",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NC2050",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1679717789",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shauna Mangum, RN
• Rachel Lynn Mankowitz
• Daniel Brooks Mannas, M.D.
• Maureen Mannas, MD
• Stephen Mannas, MD
• Patty A Manuelito
• Barbara J Manus-Greider, LMSW
• Jaisiah Manus
• Many Rivers Transitional Therapy Solutions LLC
• Jean Madeleine Manz, LMFT

• Pediatrics Physician in Farmington, NM
• Providers in Farmington, NM by specialty
• Pediatrics Physician in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.