Wallace Gladden

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

P27997 Issued in MD

Practice address

Unm Department of Orthopaedics and
1 University of New Mexico
Albuquerque, NM 87131-0001

Phone

(505) 272-6444

Fax

(505) 272-8099

NPI assigned

Jul 9, 2009

Last updated

Mar 22, 2017By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NM

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 1

Specialty

General PracticeAlso: Physical Medicine and Rehabilitation

Education

Howard University College of Medicine, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Manzano Medical Group, P.C.Group PAC ID 9830093707, 2 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• La Vita Bella Home Health, LLC Home health agency, Rio Rancho, NM, CCN 327234
• Rehoboth McKinley Christian Health Care Services Hospital, Gallup, NM, CCN 321313
• Presbyterian Hospital Hospital, Albuquerque, NM, CCN 320021
• Lovelace Unm Rehabilitation Hospital Inpatient rehabilitation facility, Albuquerque, NM, CCN 323028

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Manzano Medical Group, P.C.

  • Physical Medicine & Rehabilitation Physician
  • Albuquerque, NM
  • NPI 1881704096
  Medicare reassignment Care Compare group NPD
• Lovelace Unm Rehabilitation Hospital LLC

  • Rehabilitation Hospital
  • Albuquerque, NM
  • NPI 1700325677
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• La Vita Bella Home Health LLC

  • Home Health Agency
  • Rio Rancho, NM
  • NPI 1821599226
  Care Compare affiliation
• Lovelace Unm Rehabilitation Hospital LLC

  • Rehabilitation Hospital
  • Albuquerque, NM
  • NPI 1700325677

  Inpatient rehabilitation facility

  Care Compare affiliation
• Presbyterian Healthcare Services

  dba Presbyterian Hospital

  • General Acute Care Hospital
  • Albuquerque, NM
  • NPI 1215913470
  Care Compare affiliation
• Presbyterian Healthcare Services

  dba Presbyterian Kaseman Psych Unit

  • Psychiatric Hospital Unit
  • Albuquerque, NM
  • NPI 1598740482
  Care Compare affiliation
• Rehoboth McKinley Christian Health Care Services, Inc

  • Rural Health Clinic/Center
  • Gallup, NM
  • NPI 1689779860

  Hospital

  Care Compare affiliation
• Rehoboth McKinley Christian Health Care Services, Inc.

  dba RMCHCS Hospital

  • Critical Access Hospital
  • Gallup, NM
  • NPI 1720084999
  Care Compare affiliation

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

{
    "created_epoch": "1247097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490140800000",
    "number": "1689803827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "933 BRADBURY DR SE",
            "address_2": "SUITE 2222",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871064374",
            "telephone_number": "505-272-3120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "UNM DEPARTMENT OF ORTHOPAEDICS AND",
            "address_2": "1 UNIVERSITY OF NEW MEXICO",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871310001",
            "telephone_number": "505-272-6444",
            "fax_number": "505-272-8099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLADDEN",
        "first_name": "WALLACE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-07-09",
        "last_updated": "2017-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "MD",
            "license": "P27997",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Becky K Gius
• John M Givens
• William Shane Givens
• Giving Tree Counseling, LLC
• Janice Gjertson, LPCC
• Jacqueline Gladwell, MD
• Hayley Glantz, DO
• James G Glasa, DMD
• Carla J Glaser, MS, CCC-SLP
• Cyril Henry Glaser, PT, DPT

• Physical Medicine & Rehabilitation Physician in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Physical Medicine & Rehabilitation Physician in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2017; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.