NPIMap

Organization Active NPI

University of New Mexico Medical Group, Inc.

  • Student Health Clinic/Center
  • Albuquerque, NM
National Provider Identifier
1992966923
Registry record updated Jun 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student Health Clinic/CenterTaxonomy code 261QS1000X
License
425 Issued in NM
Legal business name
UNIVERSITY OF NEW MEXICO MEDICAL GROUP, INC.
Practice address
800 Odelia Rd NE
Albuquerque, NM 87102-1619
Phone
(505) 244-1330
Fax
(505) 244-1331
NPI assigned
Jun 23, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2008

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

Authorized official

Name
Mr. Anthony Masciatra
Title
Ceo
Phone
(505) 272-8950

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student Health Clinic/Center 261QS1000X 425 NM Primary

Addresses

Primary practice location

800 Odelia Rd NE
Albuquerque, NM 87102-1619

Mailing address

University of New Mexico School Based Health CTRS
Msc09 5040 1 University of New Mexico
Albuquerque, NM 87131-0001
Phone (505) 272-0457

Other identifiers 1

IdentifierTypeStateIssuer
3A01MedicaidNM

National Provider Directory

National Provider Directory
Tax ID family
University of New Mexico Dental Services17 organizations share this tax ID, including this one

Other organizations with this tax ID 16

Organizations that report the same tax identification number in the National Provider Directory.

View all 16

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1214179200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214179200000",
    "number": "1992966923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "UNIVERSITY OF NEW MEXICO SCHOOL BASED HEALTH CTRS",
            "address_2": "MSC09 5040 1 UNIVERSITY OF NEW MEXICO",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871310001",
            "telephone_number": "505-272-0457",
            "fax_number": "505-272-2043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 ODELIA RD NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871021619",
            "telephone_number": "505-244-1330",
            "fax_number": "505-244-1331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY OF NEW MEXICO MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-23",
        "last_updated": "2008-06-23",
        "status": "A",
        "authorized_official_last_name": "MASCIATRA",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "505-272-8950",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QS1000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Student Health",
            "state": "NM",
            "license": "425",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3A01",
            "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 Jun 23, 2008; 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.