Susan D Roberts (NPI# 1437158896, PAC ID# 2062540370) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is FAMILY MEDICINE.
Nation Provider ID (NPI) | 1437158896 |
PAC ID by PECOS | 2062540370 |
Professional Enrollment ID | I20130620000397 |
Full Name | Susan D Roberts |
Organization Legal Name | DAVITA MEDICAL GROUP NEW MEXICO, LLC |
Address |
13701 Encantado Rd Ne Albuquerque NM 87123-2275 |
Phone Number | 5052378700 |
Gender | F |
Medical School | COLLEGE OF OSTEO OF THE PACIFIC |
Graduation Year | 1994 |
Primary Specialty | FAMILY MEDICINE |
Group Practice PAC ID | 9032125810 |
Number of Group Practice Members | 142 |
Accepts Medicare Assignment | Y |
Claim Control Number (CCN) | Legal Business Name |
---|---|
320017 | LOVELACE WOMEN'S HOSPITAL |
Address | Phone | Organization |
---|---|---|
13701 Encantado Rd Ne, Albuquerque, NM 87123-2275 | 5052378700 | DAVITA MEDICAL GROUP NEW MEXICO, LLC |
Organization Legal Name | DAVITA MEDICAL GROUP NEW MEXICO, LLC |
Physicians | 180 |
Name | Specialty | Organization | Address |
---|---|---|---|
Michael A Bergeron | Family Medicine | Davita Medical Group New Mexico, LLC | 4010 Montgomery Blvd Ne, Albuquerque, NM 87109-1186 |
Theresa Toomey | Nurse Practitioner | Davita Medical Group New Mexico, LLC | 2929 Coors Blvd Nw, Albuquerque, NM 87120-1173 |
Baudilio J Velez | Nurse Practitioner | Davita Medical Group New Mexico, LLC | 5150 Journal Ctr Blvd Ne, Fl 3, Albuquerque, NM 87109-5900 |
Nicole Ann Badillo | Nurse Practitioner | Davita Medical Group New Mexico, LLC | 2901 Transport St Se, Albuquerque, NM 87106-4382 |
Elea Ann Martinez | Nurse Practitioner | Davita Medical Group New Mexico, LLC | 4333 Pan American Fwy Ne, Suite C, Albuquerque, NM 87107-6833 |
Ryan P Tyner | General Surgery | Davita Medical Group New Mexico, LLC | 5400 Gibson Blvd Se, Albuquerque, NM 87108-4729 |
Fabio Spadaro | Family Medicine | Davita Medical Group New Mexico, LLC | 1721 Rio Rancho Dr Nw, Albuquerque, NM 87105-5904 |
Patricia A Carabajal | Family Medicine | Davita Medical Group New Mexico, LLC | 2121 Juan Tabo Blvd Ne, Albuquerque, NM 87112-3307 |
Henry Anthony Garcia | Family Medicine | Davita Medical Group New Mexico, LLC | 9101 Montgomery Blvd Ne, Albuquerque, NM 87111-2405 |
Edna L Lopez | Nurse Practitioner | Davita Medical Group New Mexico, LLC | 4700 Jefferson St Ne, Suite 800, Albuquerque, NM 87109-2132 |
Street Address |
13701 ENCANTADO RD NE |
City | ALBUQUERQUE |
State | NM |
Zip | 87123-2275 |
Name | Specialty | Organization | Address |
---|---|---|---|
Uchenna Maria Ohiri | Nurse Practitioner | Davita Medical Group New Mexico, LLC | 13701 Encantado Rd Ne, Albuquerque, NM 87123-2275 |
Keith A Steichen | Family Medicine | Davita Medical Group New Mexico, LLC | 13701 Encantado Rd Ne, Albuquerque, NM 87123-2275 |
Name | Specialty | Organization | Address |
---|---|---|---|
James Curry | Clinical Social Worker | 13701 Skyline Rd Ne, Suite A, Albuquerque, NM 87123-2327 |
City | ALBUQUERQUE |
Zip Code | 87123 |
Specialty | FAMILY MEDICINE |
City + Specialty | ALBUQUERQUE + FAMILY MEDICINE |
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Data Provider | Centers for Medicare & Medicaid Services (CMS) |
Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.