NPIMap

Organization Active NPI

Anesthesia Associates of New Mexico P C

  • Specialist
  • Albuquerque, NM
National Provider Identifier
1912900754
Registry record updated Sep 27, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
PT0002685 Issued in NM
Legal business name
ANESTHESIA ASSOCIATES OF NEW MEXICO P C
Practice address
1100 Central Ave SE
Albuquerque, NM 87106-4930
Phone
(505) 841-1234
Fax
(505) 841-1956
NPI assigned
May 24, 2005
Last updated
Sep 27, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2007

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

Authorized official

Name
Kishore B. Manne, M.D.NPI 1710980313
Title
President
Phone
(505) 260-4300

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X PT0002685 NM Primary

Addresses

Primary practice location

1100 Central Ave SE
Albuquerque, NM 87106-4930

Mailing address

1720 Louisiana Blvd NE
Ste 401
Albuquerque, NM 87110-7020
Phone (505) 260-4300

Other identifiers 4

IdentifierTypeStateIssuer
0747917MedicaidTX
94001930MedicaidCO
002MedicaidNM
51227MedicaidNM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040325000455 NM Part B Supplier - Clinic/Group Practice 4385536564 Receives reassigned benefits from 161 practitioners
Practice locations: Albuquerque, NM; Socorro, NM; Santa Fe, NM; Artesia, NM

National Provider Directory

National Provider Directory

Locations

10010 Coors Blvd NW
Albuquerque, NM 87114
Phone (505) 420-5668

5203 Juan Tabo Blvd NE
Ste 1B
Albuquerque, NM 87111
Phone (505) 369-0066

Practitioners & affiliated clinicians

Practitioners 194

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.

View all 194

NPI Registry JSON

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

{
    "created_epoch": "1116892800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1190851200000",
    "number": "1912900754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1720 LOUISIANA BLVD NE",
            "address_2": "STE 401",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871107020",
            "telephone_number": "505-260-4300",
            "fax_number": "505-260-4338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 CENTRAL AVE SE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871064930",
            "telephone_number": "505-841-1234",
            "fax_number": "505-841-1956"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANESTHESIA ASSOCIATES OF NEW MEXICO P C",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-05-24",
        "last_updated": "2007-09-27",
        "status": "A",
        "authorized_official_last_name": "MANNE",
        "authorized_official_first_name": "KISHORE",
        "authorized_official_middle_name": "B.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "505-260-4300",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NM",
            "license": "PT0002685",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0747917",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "94001930",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002",
            "state": "NM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "51227",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.