PATRICK M. DALESSIO (NPI# 1699782102) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699782102 |
| Entity Type | Individual |
| Full Name | PATRICK M. DALESSIO |
| Credential | PA-C |
| 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 | 5057268671 |
| Mailing Telephone | 5057221000 |
| Mailing Fax Number | 5057268671 |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2012-07-18 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363A00000X | Physician Assistant | PA10004407 | WA | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
PA10004407 | WA | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
PA10004407 | WA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | L&I PIN | 0197285 | 01 |
| WA | 8354375 | 05 | |
| WA | REGENCE BLUE SHIELD PIN | 06173U | 01 |
| Street Address |
516 EAST NIZHONI BLVD. |
| City | GALLUP |
| State | NM |
| Zip Code | 87301-1337 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386644052 | Dorothy Whitaker | Specialist | 516 East Nizhoni Blvd., Gallup, NM 87301-1337 | 2005-07-26 |
| 1932516333 | Patricia Pate | Nurse Practitioner | 516 East Nizhoni Blvd., Gallup, NM 87301-1337 | 2014-07-17 |
| 1013273325 | Maxine Rose Horton | Nurse Practitioner | 516 East Nizhoni Blvd., Gallup, NM 87301-1337 | 2012-04-11 |
| 1710289723 | Jordan Clifford Burnett | Physical Therapist | 516 East Nizhoni Blvd., Gallup, NM 87301-1337 | 2010-11-23 |
| 1881907889 | Sheryl Bahe Livingston | Counselor | 516 East Nizhoni Blvd., Gallup, NM 87301-1337 | 2010-07-19 |
| 1366673113 | Matthew Dennis Jones | Psychologist | 516 East Nizhoni Blvd., Gallup, NM 87301 | 2009-07-28 |
| 1134361785 | Jennifer Nadine Jaggi | Obstetrics & Gynecology | 516 East Nizhoni Blvd., Gallup, NM 87301-1337 | 2009-03-28 |
| 1558515940 | David Benjamin Good II | Registered Nurse | 516 East Nizhoni Blvd., Gallup, NM 87301-1337 | 2008-11-11 |
| 1689839482 | Kadallah Zizwee Brandy | Internal Medicine | 516 East Nizhoni Blvd., Gallup, NM 87301-1337 | 2008-07-22 |
| 1013184654 | Juan Pablo Rossini | Anesthesiology | 516 East Nizhoni Blvd., Gallup, NM 87301-1337 | 2008-05-13 |
| 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 | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386284602 | Christopher Whorley | Physician Assistant | 4683 Idlewilde Ln Se, Albuquerque, NM 87108-3421 | 2020-01-15 |
| 1053836809 | Alysha Gallegos | Physician Assistant | 6112 Molinero Ct Sw, Albuquerque, NM 87105-6814 | 2017-08-13 |
| 1164978540 | Deborah L Thorne | Physician Assistant | 111 W Lucero Ave Ste 6, Las Cruces, NM 88005-1829 | 2016-08-26 |
| 1134572738 | Weston Bradley Graff | Physician Assistant | 703 Christopher Dr, Belen, NM 87002-2617 | 2016-07-19 |
| 1295194629 | Ryan Grange | Physician Assistant | 1851 Old Highway 66 Unit 1, Edgewood, NM 87015 | 2016-02-12 |
| 1720445562 | Rebecca Gahan Brown | Physician Assistant | 150 N Roadrunner Pkwy, Las Cruces, NM 88011 | 2016-01-25 |
| 1508232240 | Edward R Watson | Physician Assistant | 2530 S Telshor Blvd Ste 207, Las Cruces, NM 88011-4975 | 2015-08-17 |
| 1306225180 | Allison Rose Crossey | Physician Assistant | 201 Cedar Street Se, Suite 6600, Albuquerque, NM 87106 | 2015-05-26 |
| 1528452208 | Taylor Bottari | Physician Assistant | 208 W Dl Ingram, Cannon Afb, NM 88103 | 2015-03-20 |
| 1336543115 | Pamela O Black Md, P.a., Dba Quadra Health Institute | Physician Assistant | 3820 Commons Ave Ne # M, Albuquerque, NM 87109-5831 | 2014-10-22 |
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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.