Manzano Medical Group, P.C.

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

Legal business name

MANZANO MEDICAL GROUP, P.C.

Practice address

505 Elm St NE
Albuquerque, NM 87102-2500

Phone

(505) 727-4919

Fax

(505) 727-4915

NPI assigned

Aug 30, 2006

Organization subpart

No

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

Authorized official

Name

John Henry Sloan, M.D.NPI 1922117019

Title

Ceo/President

Phone

(505) 727-4919

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NM

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• John Henry Sloan, M.D.

  • Physical Medicine & Rehabilitation Physician
  • Albuquerque, NM
  • NPI 1922117019
  Medicare reassignment Care Compare group NPD Authorized official
• Wallace Gladden

  • Physical Medicine & Rehabilitation Physician
  • Albuquerque, NM
  • NPI 1689803827
  Medicare reassignment Care Compare group NPD
• Reza Ehsanian, MD

  • Physical Medicine & Rehabilitation Physician
  • Albuquerque, NM
  • NPI 1376988535
  Medicare reassignment NPD
• Athanasios Kostandinos Manole, MD

  • Interventional Pain Medicine Physician
  • Albuquerque, NM
  • NPI 1780002220

  Multi-Specialty

  Medicare reassignment NPD
• Loc Van DO, PHYSICIAN ASSISTANT

  • Physician Assistant
  • Albuquerque, NM
  • NPI 1831628841
  Medicare reassignment
• Michael A Domino, PA-C

  • Physician Assistant
  • Albuquerque, NM
  • NPI 1689837916
  Medicare reassignment
• Andrea K Thelen, PA

  • Physician Assistant
  • Albuquerque, NM
  • NPI 1629394945
  Medicare reassignment
• Rafael M Garcia, PA-C

  • Physician Assistant
  • Phoenix, AZ
  • NPI 1144317637

  NM

  Medicare reassignment
• Carlos J Esparza, MD

  • Physical Medicine & Rehabilitation Physician
  • Albuquerque, NM
  • NPI 1255399630
  NPD (past)
• Theresa Michelle Genovese Elliott, MD

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Santa Fe, NM
  • NPI 1801830179
  NPD (past)
• Nancy Greces, MD

  • Internal Medicine Physician
  • Albuquerque, NM
  • NPI 1558384644
  NPD (past)
• Colleen S Weston, D.O.

  • Infectious Disease Physician
  • Northville, MI
  • NPI 1760402796
  NPD (past)

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1881704096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 25701",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871250701",
            "telephone_number": "505-727-4919",
            "fax_number": "505-727-4915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 ELM ST NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871022500",
            "telephone_number": "505-727-4919",
            "fax_number": "505-727-4915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MANZANO MEDICAL GROUP, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-30",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SLOAN",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "HENRY",
        "authorized_official_title_or_position": "CEO/PRESIDENT",
        "authorized_official_telephone_number": "505-727-4919",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "A5074",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Patrick James Manzanares, LCSW, CHES
• Rosanna Yvette Manzanares, B.S
• Stefanie Manzanares, FNP-C, FNP-BC
• Manzanilla Health LLC
• Alexander Alberto Manzano Finol, MD
• Jenny Mao
• Daniel Maoz-Metzl, MD
• Martha T Mapalo, MBCHB
• Maple Street ABA NM LLC
• Baila Maqbool

• 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 Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.