NPIMap

Individual provider Active NPI

Oscar Palomo, MD

  • Emergency Medicine Physician
  • Gallup, NM
National Provider Identifier
1861464141
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
94-350 Issued in NM
Practice address
1901 Redrock Dr
Gallup, NM 87301-5683
Phone
(505) 863-7000
NPI assigned
Feb 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 94-350 NM Primary

Addresses

Primary practice location

1901 Redrock Dr
Gallup, NM 87301-5683

Mailing address

1901 Redrock Dr
PFS Dept
Gallup, NM 87301-5683
Phone (505) 863-7000

Other identifiers 8

IdentifierTypeStateIssuer
366767OtherAZAHCCCS
10002115OtherNMLOVELACE HEALTH/SALUD
201014078OtherNMPRESBYTERIAN HEALTH/SALUD
930027304OtherRAILROAD MEDICARE
85031326887301A057OtherCHAMPUS
BCBSOtherNMNM007580
PROVP15555OtherNMMOLINA
23455MedicaidNM

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

State licenses

LicenseStateTypeSpecialty
6544NMMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
CMC Radiological Services PC Past Accepting new patients
CMC Radiological Services PC Past Accepting new patients
Western New Mexico Emergency Physicians PC Emergency Medicine PastSince Jan 1, 2007 Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1138838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1861464141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1901 REDROCK DR",
            "address_2": "PFS DEPT",
            "city": "GALLUP",
            "state": "NM",
            "postal_code": "873015683",
            "telephone_number": "505-863-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 REDROCK DR",
            "city": "GALLUP",
            "state": "NM",
            "postal_code": "873015683",
            "telephone_number": "505-863-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALOMO",
        "first_name": "OSCAR",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NM",
            "license": "94-350",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AHCCCS",
            "identifier": "366767",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LOVELACE HEALTH/SALUD",
            "identifier": "10002115",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRESBYTERIAN HEALTH/SALUD",
            "identifier": "201014078",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "930027304",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHAMPUS",
            "identifier": "85031326887301A057",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NM007580",
            "identifier": "BCBS",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MOLINA",
            "identifier": "PROVP15555",
            "state": "NM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "23455",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gallup, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.