MDLIVE MEDICAL GROUP NM LLC (NPI# 1902209497) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902209497 |
| Entity Type | Organization |
| Organization Name | MDLIVE MEDICAL GROUP NM LLC |
| Practice Address |
123 Marcy Street Santa Fe NM 87501 |
| Mailing Address |
13630 Nw 8th St Suite 205 Sunrise FL 33325-6238 |
| Practice Telephone | 8553324499 |
| Practice Fax Number | 2319324133 |
| Mailing Telephone | 9544660593 |
| Mailing Fax Number | 9542060800 |
| Enumeration Date | 2014-09-29 |
| Last Update Date | 2018-10-16 |
| Authorized Official Name | MARY JO MCINTYRE (OWNER) |
| Authorized Official Telephone | 9544660593 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101Y00000X | Counselor | Behavioral Health & Social Service Providers | ||
| N | 104100000X | Social Worker | Behavioral Health & Social Service Providers | ||
| N | 207P00000X | Emergency Medicine | Allopathic & Osteopathic Physicians | ||
| N | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians | ||
| Y | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NM | 24902021 | 05 |
| Street Address |
123 MARCY STREET |
| City | SANTA FE |
| State | NM |
| Zip Code | 87501 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841775327 | Rasanjana Bhandari | Behavior Technician | 1505 Paseo De Conquistadora, Santa Fe, NM 87501 | 2018-10-01 |
| 1497102172 | New Mexico Neurodiagnostics, LLC | Clinic/Center | 150 Washington Ave., Ste. #201-220, Office 224, Santa Fe, NM 87501 | 2016-05-23 |
| 1831557891 | Jane Berger | Social Worker | 300 Griffin St Ste 213, Santa Fe, NM 87501 | 2016-02-05 |
| 1316325061 | Serenity Wellness Center of Santa Fe, LLC | Counselor | 343 E Palace Ave, Santa Fe, NM 87501 | 2015-05-14 |
| 1396154183 | Julie Price | Counselor | 1 Montoya Cir, Santa Fe, NM 87501 | 2014-08-06 |
| 1053609487 | Michael Shawn Haner | Acupuncturist | 909 Early St., Santa Fe, NM 87501 | 2011-07-19 |
| 1396045316 | Dana Moore | Counselor | 950 Canyon Rd., Santa Fe, NM 87501 | 2010-10-25 |
| 1720394232 | Susan Nelsen | Social Worker | 118 Huddleson St, Santa Fe, NM 87501 | 2010-08-20 |
| 1033434543 | Anthony R Moya | Social Worker | 501 Franklin Ave Ofc 6, Santa Fe, NM 87501 | 2010-03-29 |
| 1346485695 | Carla Kleefeld | Counselor | 650a Santa Fe Trail, Santa Fe, NM 87501 | 2008-12-15 |
| Find all providers in zip 87501 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316589799 | Daniel Marc Sosin | Internal Medicine | 1190 S Saint Francis Dr # N-1053, Santa Fe, NM 87505-4173 | 2019-10-17 |
| 1558875260 | Northern Nm Medical Management, LLC | Internal Medicine | 1421 Luisa Street, Suite B, Santa Fe, NM 87505-4073 | 2017-11-17 |
| 1508270745 | Mehul Daulat | Internal Medicine | 2213 Brothers Rd Ste 700, Santa Fe, NM 87505 | 2014-06-16 |
| 1346595774 | Trenton Tyler Sensiba | Internal Medicine | 465 Saint Michaels Dr Ste 116, Santa Fe, NM 87505 | 2012-07-23 |
| 1902199797 | Luke Martin Gabe | Internal Medicine | 465 Saint Michaels Dr Ste 209, Santa Fe, NM 87505 | 2011-05-26 |
| 1740515584 | Hospitalists New Mexico PC | Internal Medicine | 35 Blue Jay Dr, Santa Fe, NM 87506-8509 | 2009-10-13 |
| 1336381342 | Aamer Rehman | Internal Medicine | 454 St Michaels Dr, Santa Fe, NM 87505-7602 | 2009-04-06 |
| 1366695272 | First Care Inc | Internal Medicine | 4001 Office Ct Ste 405, Santa Fe, NM 87507-4916 | 2008-10-23 |
| 1952505182 | David Steven Riley | Internal Medicine | 6 Amigos Ln, Santa Fe, NM 87508-4584 | 2007-06-12 |
| 1174743660 | Howard Neil Schwartz | Internal Medicine | 404 Brunn School Road, Building C, Santa Fe, NM 87505-2612 | 2007-04-26 |
| Find all providers in SANTA FE | ||||
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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.