MS. MAYUMI OTSUKA (NPI# 1518954999) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518954999 |
| Entity Type | Individual |
| Full Name | MS. MAYUMI OTSUKA |
| Credential | MD |
| Practice Address |
516 East Nizhoni Blvd Gallup NM 87301-1337 |
| Mailing Address |
P.o. Box 1337 Gallup NM 87305-1337 |
| Practice Telephone | 5057221000 |
| Practice Fax Number | 5057221268 |
| Mailing Telephone | 5057221000 |
| Mailing Fax Number | 5057221268 |
| Enumeration Date | 2005-09-30 |
| Last Update Date | 2016-04-29 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | 0420010593 | VT | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CO | 24559342 | 05 | |
| NM | 63139324 | 05 | |
| AZ | 811457 | 05 |
| Street Address |
516 EAST NIZHONI BLVD |
| City | GALLUP |
| State | NM |
| Zip Code | 87301-1337 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811419294 | Kristen Bekker | Registered Nurse | 516 East Nizhoni Blvd, Gallup, NM 87301 | 2017-07-07 |
| 1770013351 | Andrea Dee Cauley | Registered Nurse | 516 East Nizhoni Blvd, Gallup, NM 87301 | 2017-06-15 |
| 1154603959 | Bo Tran | Dentist | 516 East Nizhoni Blvd, Gallup, NM 87301 | 2011-09-16 |
| 1669797338 | Isaac Short | Occupational Therapist | 516 East Nizhoni Blvd, Gallup, NM 87301-1337 | 2010-04-06 |
| 1750604120 | Karen Sue Severns | Social Worker | 516 East Nizhoni Blvd, Gallup, NM 87301 | 2010-03-12 |
| 1801123559 | Vickie Becenti | Dental Assistant | 516 East Nizhoni Blvd, Gallup, NM 87301-1337 | 2009-11-17 |
| 1861629339 | Deborah Polk | Registered Nurse | 516 East Nizhoni Blvd, Gallup, NM 87301 | 2009-06-11 |
| 1801080718 | Verna Gaddy | Registered Nurse | 516 East Nizhoni Blvd, Gallup, NM 87301-1337 | 2007-09-04 |
| 1649479874 | Maricruz Merino | Internal Medicine | 516 East Nizhoni Blvd, Gallup, NM 87301-1337 | 2007-07-17 |
| 1780899203 | Mildred Lincoln | Dietitian, Registered | 516 East Nizhoni Blvd, Gallup, NM 87301 | 2007-05-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154966141 | Karen Marie Acuesta Arboleda | Registered Nurse | 516 E Nizhoni Bld., Gallup, NM 87301 | 2019-11-13 |
| 1811453707 | Kelly Dahn | Respiratory Therapist, Certified | 516 E Hizhoni Blvd, Gallup, NM 87301 | 2019-02-15 |
| 1417411232 | Frances Griego | Registered Nurse | 28b Alma Drive, Gallup, NM 87301 | 2019-01-25 |
| 1891267605 | Hozho Academy | Occupational Therapist | 306 Nm-564, Gallup, NM 87301 | 2018-12-19 |
| 1922514686 | Jjdac, LLC | Ambulance | 208 W Maloney Ave, Gallup, NM 87301 | 2017-12-18 |
| 1508382698 | Katherine L Kuehl | Pharmacist | Walgreens 1870 E Historic Highway 66, Galliup, NM 87301 | 2017-08-21 |
| 1497285001 | Jessica Kate Savant | Registered Nurse | 516 E Nazhoni Blvd, Gallup, NM 87301 | 2017-06-15 |
| 1770013385 | Nicole Aline Pavy | Registered Nurse | 516 E. Nizhioni Blvd, Gallup, NM 87301 | 2017-06-15 |
| 1730612276 | Camie Renee Nelson | Contractor | 121 Bishop Drive, Gallup, NM 87301 | 2017-04-11 |
| 1508216227 | Marriah Silversmith | Technician, Other | 3426 Blue Hill Ave, Gallup, NM 87301 | 2016-06-14 |
| Find all providers in zip 87301 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104898063 | Michelle Stam-maclaren | Pediatrics | 2111 College Drive, Rehoboth Mckinley Christian Health Care Services, Gallup, NM 87301 | 2006-02-06 |
| 1831519792 | Adam Knappe | Pediatrics | 516 E Nizhoni Blvd, Gallup, NM 87301-5748 | 2014-04-18 |
| 1649615469 | Julia Thorn | Pediatrics | 516 E Nizhoni Blvd, Gallup, NM 87301-5748 | 2013-05-07 |
| 1679830764 | Marla Jana Yazzie | Pediatrics | 516 E Nizhoni Blvd, Gallup, NM 87301-5748 | 2012-04-13 |
| 1922242965 | Melinda Kathryn Rogers | Pediatrics | 2111 College Dr, Gallup, NM 87301-5600 | 2009-04-21 |
| 1821275819 | Keea M Wesley | Pediatrics | 516 East Nizhoni Blvd., Gallup, NM 87301-1337 | 2008-01-22 |
| 1487844791 | Nicolas Lee Peters | Pediatrics | 2111 College Dr, Gallup, NM 87301-5600 | 2007-08-01 |
| 1861695348 | James Joseph Campbell | Pediatrics | 516 E. Nizhoni Blvd., Gallup, NM 87301-1337 | 2007-06-11 |
| 1477623213 | Thomas John Herr | Pediatrics | 1901 Red Rock Dr, Gallup, NM 87301-5683 | 2006-11-09 |
| 1003985417 | Carlos Manuel De Sanctis | Pediatrics | 516 E. Nizhoni Blvd., Gallup, NM 87301 | 2006-11-07 |
| Find all providers in GALLUP | ||||
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| 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.