Willie L Nunez, M.D.
Individual provider Active NPI Vascular & Interventional Radiology Physician · Albuquerque, NM
NPI 1689808693 · NPPES record last updated Jun 6, 2016
Key facts
- NPI
- 1689808693
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Vascular & Interventional Radiology Physician 2085R0204X
- License
- MD2012-0230 (NM)
- Practice address
- 601 Dr Martin Luther King Jr Ave NE
Lovelace Medical Center
Albuquerque, NM 87102-3619 - Phone
- (505) 298-0301
- NPI assigned
- May 5, 2009
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 17
Hospital & facility affiliations 9
Medicare Care Compare profile
- Specialty
- Diagnostic Radiology
- Education
- University of New Mexico School of Medicine, 2009
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- DHHS IHS Phoenix Area
White Mountain Radiology
Summit Healthcare Association
Frances Mahon Deaconess Hospital
DHHS IHS Phoenix Area
Practice addresses (Care Compare)
200 W Hospital Dr
Whiteriver, AZ 85941-0860
Phone 92833849113532
2200 E Show Low Lake Rd
Show Low, AZ 85901-7831
Phone (928) 537-4375
621 3Rd St S
Glasgow, MT 59230-2604
Phone (406) 228-3500
Highway 264 Milepost
Suite 388
Polacca, AZ 86042-4000
N Cromwell Rd
Cibecue Health Ctr
Cebecue, AZ 85911-0037
Phone 92833849113532
PO Box
4000 Hwy 264 Milepost 388
Polacca, AZ 86042-4000
PO Box
Suite 860
Whiteriver, AZ 85941-0860
Hospital & facility affiliations
- Summit Healthcare Regional Medical Center
- Whiteriver PHS Indian Hospital
- Hopi Health Care Center
- Frances Mahon Deaconess Hospital
- Cobre Valley Regional Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (4 enrollments) in CA, AZ, TX, MT
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200214000859 | CA | Practitioner - Diagnostic Radiology | 5193042174 | |
| I20210107002901 | AZ | Practitioner - Diagnostic Radiology | 5193042174 | Reassigns benefits to 3 organizations |
| I20210507000501 | TX | Practitioner - Diagnostic Radiology |
5193042174 | Reassigns benefits to 2 organizations |
| I20250122002522 | MT | Practitioner - Diagnostic Radiology | 5193042174 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD2012-230 | NM | MD | Diagnostic Radiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Frances Mahon Deaconess Hospital | Diagnostic Radiology | Current |
Accepting new patients |
| Scripps Health | Current | Accepting new patients | |
| DHHS IHS Phoenix Area | Current |
Accepting new patients | |
| Frances Mahon Deaconess Hospital | Current |
Accepting new patients | |
| Summit Healthcare Association | Current |
Accepting new patients | |
| DHHS IHS Phoenix Area | Family Medicine | Current |
Accepting new patients |
| White Mountain Radiology | Diagnostic Radiology | Current |
Accepting new patients |
| DHHS IHS Phoenix Area | Current |
Accepting new patients | |
| Frances Mahon Deaconess Hospital | Current |
Accepting new patients | |
| Kennewick Radiology Group, PC | Diagnostic Radiology | Past |
Accepting new patients |
Locations
2200 E Show Low Lake Rd
Show Low, AZ 85901
Phone (928) 537-4375
4951 S White Mountain Rd
Show Low, AZ 85901
Phone (928) 532-5848
621 3rd St S
Glasgow, MT 59230
Phone (406) 228-3500
Interoperability endpoints
- wnunez329308@scrippshlth.medalliesdirect.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | MD2012-230 | NM | |
| Vascular & Interventional Radiology Physician | 2085R0204X | MD2012-0230 | NM | Yes |
Addresses
Primary practice location
601 Dr Martin Luther King Jr Ave NE
Lovelace Medical Center
Albuquerque, NM 87102-3619
Mailing address
PO Box 4934
Albuquerque, NM 87196-4934
Phone (505) 298-0301
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 31027083 | Medicaid | NM |
Other providers in Albuquerque, NM
- Karyn Marie Nunez
- Kelly Marie Nunez
- Mirna Nunez
- Nicole Knowlton Nunez
- Rebecca Renee Nunez
- George Nurnberg
- Nursefinders, LLC
- Linda Nusbaum
- Alexandra Nutima
- Nutrition With Szandra, LLC
All providers in Albuquerque, NM · Vascular & Interventional Radiology Physician 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 Jun 6, 2016. 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.