Gregory J Maroney, PA-C
Individual provider Active NPI Medical Physician Assistant · Moriarty, NM
NPI 1972550184 · NPPES record last updated Apr 5, 2018
Key facts
- NPI
- 1972550184
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Medical Physician Assistant 363AM0700X
- License
- PA2003-0005 (NM)
- Practice address
- 1108 W US Route 66
Moriarty, NM 87035-1006 - Phone
- (505) 832-4434
- Fax
- (505) 832-5024
- NPI assigned
- May 31, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 10
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NM
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20060104000156 | NM | Practitioner - Physician Assistant | 4284655127 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA2003-0005 | NM | MD | Medical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| McLeod Medical Centers of NM, Inc. | Current |
Accepting new patients | |
| New Mexico Pain and Spine Institute, a Professional Corporation | Past |
Accepting new patients | |
| Santa Fe Pain & Spine Specialists PC | Past | Accepting new patients | |
| Santa Clara Health Center | Past |
Accepting new patients | |
| Santo Domingo Health Clinic | Past | Accepting new patients | |
| Cochiti Health Clinic | Past | Accepting new patients | |
| San Felipe Health Clinic | Past | Accepting new patients | |
| Osuna Medical Associates, PA | Past | Accepting new patients | |
| Modern Pain & Spine PC | Past | Accepting new patients |
Locations
12127 N State Highway 14
Ste 5
Cedar Crest, NM 87008
Phone (505) 281-2460
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | PA2003-0005 | NM | Yes |
Addresses
Primary practice location
1108 W US Route 66
Moriarty, NM 87035-1006
Mailing address
12127B Hwy 14N Suite 5
Cedar Crest, NM 87008-9499
Phone (505) 281-5180
Other providers in Moriarty, NM
- Kristen K Leeson
- Sara Lombardi
- Sarah Jill Lyon
- Angela Mabry
- Christina Magnuson
- Carla Martin
- Pamela C Martin
- Melissa Jean Martinez
- Sharon McBride
- Mind-Body Therapeutics
All providers in Moriarty, NM · Medical Physician Assistant 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 Apr 5, 2018. 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.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.