Laguna Healthcare Corporation
Organization Active NPI Family Medicine Physician · Paraje, NM
NPI 1962001024 · NPPES record last updated Jan 7, 2021
Key facts
- NPI
- 1962001024
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- Legal business name
- LAGUNA HEALTHCARE CORPORATION
- Practice address
- 6 Basswood Rd
Paraje, NM 87007 - Phone
- (505) 552-5664
- NPI assigned
- Oct 20, 2020
- Organization subpart
- No
Authorized official
- Name
- Carrie L Sarnicky
- Title
- Ceo
- Phone
- (505) 552-5664
Practitioners 93
-
David William Lavender, M.D.
-
Mariana Mejia Botero, M.D.
-
Minhnga Tran, D.O.
-
Jeffrey J Juchau, M.D.
-
Emem Ukpabio, FNP
-
Charles M Davis, M.D.
-
Christian Joseph Ingui, M.D.
-
David Ishimitsu, M.D.
-
Paulette A Kirby, FNP
-
Jose A Ospina, MD, PHD
-
Ari D Plosker, M.D.
-
Adriana Romero, D.O.
-
Alix Vincent, MD
-
Miranda C Haley, M.D.
-
Claudia Erin Hannah, DDS
-
Kimberly Jaramillo, RDN
-
Alexandra Schroeder, RDN, LD
-
Alberta Diane Espinoza-Lyons, FNP-BC
-
Sarah Michaels, DO, MBA
-
Lilybell Onyewuenyi, FNP
-
Anthony Fleg, MD, MPH
-
Jessie J. Lundquist, PHD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20210119000388 | TX | Part B Supplier - Clinic/Group Practice | 2365855079 |
Receives reassigned benefits from 23 practitioners Practice locations: Paraje, NM |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | Yes | ||
| Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | 332800000X |
Addresses
Primary practice location
6 Basswood Rd
Paraje, NM 87007
Mailing address
PO Box 1407
Laguna, NM 87026-1407
Phone (505) 552-5664
Other names
- Laguna Community Health Center
Other providers in Paraje, NM
- Kimberly Chapman-Natewa
- Claudia Erin Hannah
- Laguna Healthcare Corporation
- Laguna Healthcare Corporation
- Mariana Mejia Botero
- Nicolas Milligan
- Lori Ann Ortiz
- Pueblo of Laguna
- Marian Ramsey-Ford
All providers in Paraje, NM · Family Medicine Physician in New Mexico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 7, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.