Individual provider Active NPI

David L Clanon, MD

  • Internal Medicine Physician
  • Albuquerque, NM
National Provider Identifier
1750475125
Registry record updated May 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
96215 Issued in NM
Practice address
1100 Central Ave SE FL 4B
PMG Hospitalists
Albuquerque, NM 87106-4930
Phone
(505) 724-6124
Fax
(505) 724-6125
NPI assigned
Oct 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 9, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 96215 NM Primary

Addresses

Primary practice location

1100 Central Ave SE FL 4B
PMG Hospitalists
Albuquerque, NM 87106-4930

Mailing address

PO Box 26666
PHS Provider Enrollment
Albuquerque, NM 87125-6666
Phone (505) 923-5356

Other identifiers 1

IdentifierTypeStateIssuer
000Q5684MedicaidNM

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20040202000734 NM Practitioner - Internal Medicine 6204739568 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of California, Davis School of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hospitalist Medicine Physicians of Texas PLLCGroup PAC ID 3476688318, 685 clinicians
Southwest Medical Associates, LLCGroup PAC ID 7214831114, 326 clinicians

Practice addresses (Care Compare)

2100 N Martin Luther King Jr Blvd
Plains Regional Medical Center
Clovis, NM 88101-9412
Phone (575) 769-2141

2400 Unser Blvd SE
Rust Medical Center
Rio Rancho, NM 87124-4740
Phone (505) 253-7878

601 Dr Martin Luther King Jr Ave NE
Albuquerque, NM 87102-3619
Phone (505) 727-8000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
96215NMMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hospitalist Medicine Physicians of Texas, PLLC Family Medicine CurrentSince Oct 1, 2015 Accepting new patients
Unm Medical Group, Inc. CurrentSince Jul 25, 2018 Accepting new patients
Southwest Medical Associates, LLC Family Medicine CurrentSince Nov 1, 2023 Accepting new patients
Unm Medical Group Inc CurrentSince Jul 25, 2018 Accepting new patients
Southwest Medical Associates, LLC Family Medicine CurrentSince Nov 1, 2023 Accepting new patients
Presbyterian Healthcare Services Internal Medicine Past Accepting new patients
Optumcare New Mexico LLC Family Medicine Past Accepting new patients
Lovelace Health System, LLC Past Accepting new patients

Locations

4701 Montgomery Blvd NE
Albuquerque, NM 87109
Phone (505) 727-2000

4101 Indian School Rd NE
Ste 110
Albuquerque, NM 87110
Phone (505) 727-8360

500 Walter St NE
Ste 301
Albuquerque, NM 87102
Phone (505) 727-2850

8080 Academy Rd NE
Albuquerque, NM 87111
Phone (505) 727-3400

601 Martin Luther King Ave NE
Albuquerque, NM 87102
Phone (505) 727-8040

4705 Montgomery Blvd NE
Ste 201
Albuquerque, NM 87109
Phone (505) 727-6550

715 Martin Luther King Ave NE
Ste 301
Albuquerque, NM 87102
Phone (505) 727-4500

2100 N Mlk Blvd
Clovis, NM 88101
Phone (505) 769-2141

2400 Unser Blvd SE
Rio Rancho, NM 87124
Phone (505) 253-0000

2211 Lomas Blvd NE
Unm, NM 87106
Phone (505) 272-1111

Interoperability endpoints

  • Direct secure messaging: dclanon29736@direct.phs.org
  • Direct secure messaging: dclanon888892@ahs.direct-ci.com

Organizations & group practices 8

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.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715212800000",
    "number": "1750475125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 26666",
            "address_2": "PHS PROVIDER ENROLLMENT",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871256666",
            "telephone_number": "505-923-5356",
            "fax_number": "505-923-5354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 CENTRAL AVE SE FL 4B",
            "address_2": "PMG HOSPITALISTS",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871064930",
            "telephone_number": "505-724-6124",
            "fax_number": "505-724-6125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLANON",
        "first_name": "DAVID",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2024-05-09",
        "certification_date": "2024-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NM",
            "license": "96215",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000Q5684",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.