Active NPI
Jameela Bai Tiku, M.D.
- Gynecology Physician
- Raton, NM
National Provider Identifier
1740377290
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gynecology Physician
- License
- 76-108
- Practice address
- 130 S 3Rd St
Raton, NM 87740-3910 - Phone
- (575) 445-5548
- Fax
- (575) 445-5560
- NPI assigned
- Oct 6, 2006
- Last updated
- Jul 29, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gynecology Physician | 207VG0400X | 76-108 | NM | Primary |
Addresses
Primary practice location
130 S 3Rd St
Raton, NM 87740-3910
Mailing address
PO Box 968
Raton, NM 87740-0968
Phone (575) 445-5548
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 27847 | Medicaid | NM |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160092800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1217289600000",
"number": "1740377290",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 968",
"city": "RATON",
"state": "NM",
"postal_code": "877400968",
"telephone_number": "575-445-5548",
"fax_number": "575-445-5560"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "130 S 3RD ST",
"city": "RATON",
"state": "NM",
"postal_code": "877403910",
"telephone_number": "575-445-5548",
"fax_number": "575-445-5560"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TIKU",
"first_name": "JAMEELA",
"middle_name": "BAI",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-06",
"last_updated": "2008-07-29",
"status": "A"
},
"taxonomies": [
{
"code": "207VG0400X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology, Gynecology",
"state": "NM",
"license": "76-108",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "27847",
"state": "NM"
}
],
"endpoints": [],
"other_names": []
}Other providers in Raton, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.