SHANTI BALKISSOON-CASTILLO (NPI# 1063418556) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063418556 |
| Entity Type | Individual |
| Full Name | SHANTI BALKISSOON-CASTILLO |
| Credential | DPM |
| Practice Address |
7700 Menaul Blvd Ne Ste D Albuquerque NM 87110-4639 |
| Mailing Address |
7700 Menaul Blvd Ne Ste D Albuquerque NM 87110-4639 |
| Practice Telephone | 5052994487 |
| Practice Fax Number | 5052994498 |
| Mailing Telephone | 5052994487 |
| Mailing Fax Number | 5052994498 |
| Enumeration Date | 2005-06-21 |
| Last Update Date | 2019-05-30 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213ES0103X |
Podiatrist Specialization: Foot & Ankle Surgery |
286 | NM | Podiatric Medicine & Surgery Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NM | 79774059 | 05 | |
| NM | PRESBYTERIAN HEALTH PLAN | 77777 | 01 |
| NM | BLUE CROSS BLUE SHIELD | NM005433 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 7700 Menaul Blvd Ne Ste D, Albuquerque, NM 87110 | 5052994487 | 5052994498 |
| Street Address |
7700 MENAUL BLVD NE STE D |
| City | ALBUQUERQUE |
| State | NM |
| Zip Code | 87110-4639 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104483544 | Shanti Balkissoon-castillo Dpm LLC | Clinic/Center | 7700 Menaul Blvd Ne, Ste D, Albuquerque, NM 87110-4639 | 2019-05-21 |
| 1538430178 | Gay L Gustafson Dpm PC | Podiatrist | 7700 Menaul Blvd Ne, Ste D, Albuquerque, NM 87110-4616 | 2012-01-12 |
| 1134390073 | Gary D Prant | Durable Medical Equipment & Medical Supplies | 7700 Menaul Blvd Ne, Ste D, Albuquerque, NM 87110 | 2008-03-19 |
| 1003980178 | Gay L Gustafson | Podiatrist | 7700 Menaul Blvd Ne, Ste D, Albuquerque, NM 87110-4616 | 2006-11-20 |
| 1841219904 | Raymond Stephen Delvalle | Dentist | 7700 Menaul Blvd Ne, Albuquerque, NM 87110-4616 | 2006-07-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215550199 | Sabrina Jennifer Lujan | Counselor | 8401 Constitution Ave Nw, Albuquerque, NM 87110 | 2020-05-26 |
| 1649829318 | Robert D. Oliver | Technician | 2705 Texas Street Ne, Albuquerque, NM 87110 | 2019-09-05 |
| 1033770904 | Life Re-created LLC | Counselor | 3939 San Pedro Dr. Ne, Bld C, Ste 8, Albuquerque, NM 87110 | 2019-06-21 |
| 1497319693 | Clear Choice Vision Care, LLC | Optometrist | 6600 Menaul Blve Ne, Suite M5a, Albuquerque, NM 87110 | 2019-04-24 |
| 1790257558 | Diana M Nicolas | Dietitian, Registered | 8300 Constitution Ave Ne Bld D, Albuquerque, NM 87110 | 2018-12-18 |
| 1689168403 | Robin N Hermes, Md, PC | Anesthesiology | 2440 Lousiana Blvd. Ne, Ste 580, Albuquerque, NM 87110 | 2018-06-15 |
| 1710481726 | Desert Mountain Eyecare LLC | Optometrist | 5504 Menaul Blvd Ne Ste Aandb, Albuquerque, NM 87110 | 2018-03-23 |
| 1659873131 | Amanda Lacasse | Registered Nurse | 6400 Uptown Blvd Ne Suite 360 West, Albuquerque, NM 87110 | 2018-03-01 |
| 1518485655 | Danielle Liegh Wyne | Counselor | 6121 Indian School Rd, Suite 141, Albuquerque, NM 87110 | 2017-09-08 |
| 1265957237 | Myrrhine Faller | Speech-Language Pathologist | 6020 Constitution Ave. Ne, Suite 4, Albuquerque, NM 87110 | 2017-08-10 |
| Find all providers in zip 87110 | ||||
| Taxonomy Code | 213ES0103X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| Specialization | Foot & Ankle Surgery |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902335102 | Sandia Foot and Ankle, LLC | Podiatrist | 8224 Louisiana Blvd Ne Ste C, Albuquerque, NM 87113-2108 | 2017-06-09 |
| 1649587676 | Omid Hazini | Podiatrist | 1501 San Pedro S.e., Albuquerque, NM 87108 | 2010-09-13 |
| 1265766992 | Uchenna Chukwurah | Podiatrist | 717 Encino Pl Ne Ste 3, Albuquerque, NM 87102-2623 | 2009-09-29 |
| 1427294982 | Roderick Douglas Farley | Podiatrist | 8001 Merissa Ln Ne, Albuquerque, NM 87122-3763 | 2009-01-05 |
| 1396857355 | Katrine Ann Mitchell | Podiatrist | 10511 Golf Course Road Nw, Suite 103, Albuquerque, NM 87048 | 2006-08-31 |
| 1720077050 | Tommy Gene Roe | Podiatrist | 9412 Indian School Rd Ne, Albuquerque, NM 87112-2878 | 2005-10-19 |
| 1366448839 | Gerard J Kerbleski | Podiatrist | 8300 Carmel Ave Ne, Ste 501, Albuquerque, NM 87122-3125 | 2005-06-21 |
| 1356347835 | Sharon Walston Kobos | Podiatrist | 5111 Juan Tabo Blvd Ne, Albuquerque, NM 87111-2672 | 2005-06-21 |
| 1821613399 | The Foot and Ankle Clinic of Albuquerque, P.C. | Podiatrist | 717 Encino Pl Ne Ste 3, Albuquerque, NM 87102-2623 | 2020-06-10 |
| 1093335473 | Seyed Faraz Heydari | Podiatrist | 1501 San Pedro Dr Se # 41, Albuquerque, NM 87108-5180 | 2020-04-25 |
| Find all providers in ALBUQUERQUE | ||||
| City | ALBUQUERQUE |
| Zip Code | 87110 |
Please comment or provide details below to improve the information on SHANTI BALKISSOON-CASTILLO.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.