BlueSalud Provider Network Directory - Blue Cross Blue Shield of ...

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Specialists Albuquerque RADECKI, RICHARD MD Provider ID: NM033654 3874 MASTHEAD NE BLDG G, 87109 505-338-2077 Fax: 505-388-1960 REHAB OCCUPATIONAL MEDICINE, Provider ID: NM007497 3811 COMMONS AVE NE , 87109 575-521-1180 REHABILITATION PARTNERS, Provider ID: NM007V58 7000 JEFFERSON ST NE , 87109 505-344-9478 Fax: 505-344-2783 SANTOS, JAMES MD Provider ID: NM009616 201 CEDAR ST SE STE 6600, 87106 505-724-4300 Languages: Spanish SLOAN, JOHN MD Provider ID: NM002721 505 ELM ST NE , 87102 505-727-4919 Languages: Spanish STOLLER, CLIFFORD MD Provider ID: NM002692 6100 SEAGULL ST NE # 106 , 87109 505-883-4395 Fax: 505-883-4397 Languages: German WILSON, ROBERT MD Provider ID: NM002742 201 CEDAR ST SE STE 6600, 87106 505-724-4300 Plastic Surgery BAACK, BRETT MD Provider ID: NM013761 1021 MEDICAL ARTS AVE NE , 87102 505-272-4264 BAACK, BRETT MD Provider ID: NM029Z58 1201 CAMINO DE SALUD NE , 87106 505-272-4946 BAACK, BRETT MD Provider ID: NM013761 2211 LOMAS BLVD NE , 87131 505-272-2336 CHAN, JENNIFER MD Provider ID: NM004W83 1020 TIJERAS AVE NE , 87106 505-842-6868 CUADROS, C LUIS MD Provider ID: NM000545 8232 LOUISIANA BLVD NE STE A, 87113 505-243-7670 Fax: 505-242-0510 Languages: Sign Language FINLEY, JOHN MD Provider ID: NM003A05 3901 ATRISCO DR NW , 87120 505-224-7575 Note: Provider is not contracted with BCBSNM for members residing in Bernalillo, Sandoval,Valencia and Torrance counties 78 FINLEY, JOHN MD Provider ID: NM003A05 8300 CONSTITUTION PL NE , 87110 505-291-2760 Fax: 505-291-2875 Note: Provider is not contracted with BCBSNM for members residing in Bernalillo, Sandoval,Valencia and Torrance counties MOREHOUSE, JEFFREY MD Provider ID: NM019D87 5006 GIBSON BLVD SE , 87108 505-262-7777 Fax: 505-262-7959 SHETTY, ANIL MD Provider ID: NM024U08 1201 CAMINO DE SALUD NE , 87102 505-272-4946 SHETTY, ANIL MD Provider ID: NM004F74 2211 LOMAS BLVD NE AMBULATORY CARE CTR 2ND FLOOR, 87131 505-272-2336 SHIMANEK, JEAN MD Provider ID: NM002557 101 HOSPITAL LOOP NE STE 115, 87109 505-883-6600 Fax: 505-883-0023 TSAO WU, GLADYS MD Provider ID: NM003W72 1020 TIJERAS NE STE 16, 87106 505-842-6868 Fax: 505-842-9325 Languages: Spanish Podiatry ASH, JEFFREY DPM Provider ID: NM005496 5111 JUAN TABO BLVD NE , 87111 505-880-1000 Fax: 505-880-1002 BALKISSOON CASTILLO, SHANTI DPM Provider ID: NM005433 8300 CARMEL NE STE 501, 87122 505-243-7600 Languages: Spanish BENALLY, ATTLEE DPM Provider ID: NM005458 2211 LOMAS BLVD NE , 87131 505-272-2231 BENALLY, ATTLEE DPM Provider ID: NM005D51 5608 ZUNI RD SE , 87108 505-262-2481 Fax: 505-265-7045 Languages: Navajo BRADY, CHAD DPM Provider ID: NM007X03 401 SAN MATEO BLVD SE , 87108 505-462-7333 Fax: 505-462-7368 Note: Provider is not contracted with BCBSNM for members residing in Bernalillo, Sandoval,Valencia and Torrance counties Languages: Spanish BRADY, CHAD DPM Provider ID: NM005490 4801 MCMAHON BLVD NW STE 110, 87114 505-872-3333 BRADY, CHAD DPM Provider ID: NM007X03 5901 HARPER DR NE , 87109 505-823-8444 Fax: 505-823-8494 Note: Provider is not contracted with BCBSNM for members residing in Bernalillo, Sandoval,Valencia and Torrance counties Languages: Spanish COBB, MATTHEW DPM Provider ID: NM00RZ70 8080 ACADEMY NE STE C, 87111 505-247-4164 Fax: 505-247-4561 COHN, RALPH DPM Provider ID: NM015417 3804 MONTGOMERY BLVD NE , 87109 505-884-7800 Fax: 505-884-7931 CORNFIELD, JAMES DPM Provider ID: NM005333 8008 MENAUL BLVD NE , 87110 505-296-5454 Fax: 505-296-1392 Languages: Spanish DRURY, ANGELA DPM Provider ID: NM021234 101 HOSPITAL LOOP NE STE 115, 87109 505-883-6600 Fax: 505-883-0023 DUMITRACHE, NELIDA DPM Provider ID: NM005D52 101 HOSPITAL LOOP NE STE 115, 87109 505-883-6600 Fax: 505-883-0023 Languages: Romanian FARLEY, RODERICK DPM Provider ID: NM005C08 8300 CARMEL AVE NE STE 501, 87122 505-797-1001 Fax: 505-828-1571 Languages: Spanish FITZPATRICK, W DPM Provider ID: NM015311 7700 MENAUL BLVD NE STE D, 87110 505-299-4487 Fax: 505-299-4498 FRAME, BRENT DPM Provider ID: NM005A28 5111 JUAN TABO BLVD NE , 87111 505-271-9900 Fax: 505-271-0217 Languages: Dutch GOODKIN, GEORGE DOM Provider ID: NM00BF33 7520 MONTGOMERY BLVD NE BLDG D12, 87109 505-881-9764 Fax: 505-881-9774 Languages: Spanish Specialists GUSTAFSON, GAY DPM Provider ID: NM015413 7700 MENAUL BLVD NE # D , 87110 505-299-4487 Fax: 505-299-4498 HAAS, MARK DPM Provider ID: NM015346 8080 ACADEMY NE STE C, 87111 505-247-4164 HAAS, ZACHARY DPM Provider ID: NM015A30 8080 ACADEMY NE STE C, 87111 505-247-4164 HO, ANDY DPM Provider ID: NM015491 3900 EUBANK NE #18 , 87111 505-881-1585 Fax: 505-828-3901 IVEY, NATHAN DPM Provider ID: NM005485 4801 MCMAHON BLVD NW STE 110, 87114 505-872-3333 IVEY, NATHAN DPM Provider ID: NM005485 5111 JUAN TABO BLVD NE , 87111 505-880-1000 KERBLESKI, GERARD DPM Provider ID: NM015369 8300 CARMEL AVE NE STE 501, 87122 505-243-7600 Languages: Spanish KILPATRICK, RICHMOND DPM Provider ID: NM005A33 201 CEDAR ST SE STE 4630, 87106 505-563-6400 Note: Provider is not contracted with BCBSNM for members residing in Bernalillo, Sandoval,Valencia and Torrance counties KILPATRICK, RICHMOND DPM Provider ID: NM005A33 5901 HARPER DR NE , 87109 505-823-8444 Fax: 505-823-8494 Note: Provider is not contracted with BCBSNM for members residing in Bernalillo, Sandoval,Valencia and Torrance counties KOBOS, SHARON DPM Provider ID: NM005A38 6821 MONTGOMERY BLVD NE STE D, 87109 505-881-8081 Fax: 505-883-5997 Languages: Spanish LAUNER, SETH DPM Provider ID: NM015489 10511 GOLF COURSE RD NW , 87114 505-232-1140 Fax: 505-232-1141 MITCHELL, KATRINE DPM Provider ID: NM005A60 10511 GOLF COURSE RD NW , 87114 505-232-1140 Fax: 505-232-1141 MOBARAK, RAHA DPM Provider ID: NM015A32 700 LOMAS BLVD NE ONE WOODWARD CENTER, 87102 505-242-3627 Fax: 505-242-2764 February 2012
Specialists NELSON, GARY DPM Provider ID: NM025349 5400 GIBSON BLVD SE , 87108 505-262-7285 Fax: 505-262-3988 OCHS, GEORGE DPM Provider ID: NM005A14 5901 HARPER DR NE , 87109 505-823-8444 Fax: 505-823-8275 Note: Provider is not contracted with BCBSNM for members residing in Bernalillo, Sandoval,Valencia and Torrance counties PACHECO, FLOYD DPM Provider ID: NM005439 201 CEDAR ST SE STE 6600, 87106 505-724-4300 PARKS, ROBERT DPM Provider ID: NM015A06 5150 JOURNAL CENTER BLVD NE , 87109 505-232-1530 Fax: 505-262-3380 PUHL, RICHARD DPM Provider ID: NM015A07 5150 JOURNAL CENTER BLVD NE , 87109 505-232-1530 Fax: 505-262-3380 PUHL, RICHARD DPM Provider ID: NM015A07 5400 GIBSON BLVD SE , 87108 505-262-7285 Fax: 505-262-3988 ROPER, RICK DPM Provider ID: NM007X02 8080 ACADEMY NE STE C, 87111 505-247-4164 Fax: 505-247-4561 SHAPIRO, FAITH DPM Provider ID: NM005354 1903 WYOMING BLVD NE STE C, 87112 505-298-7666 Fax: 505-296-0464 SIMON, JANET DPM Provider ID: NM005430 8300 CARMEL NE STE 501, 87122 505-797-1001 SOTELO, DAVID DPM Provider ID: NM005A08 8300 CARMEL NE STE 501, 87122 505-797-1001 Fax: 505-828-1571 TINGLE, RYAN DPM Provider ID: NM005A35 4801 MCMAHON BLVD STE 110, 87114 505-872-3333 Fax: 505-899-3533 TINGLE, RYAN DPM Provider ID: NM005A35 5111 JUAN TABO BLVD NE , 87111 505-880-1000 Fax: 505-880-1002 VANDERWILT, DARLO DPM Provider ID: NM015327 718 LOMAS BLVD NE STE A, 87102 505-843-6464 VAROZ, THEODORE DPM Provider ID: NM005321 1204 C CANDELARIA RD NW , 87107 505-345-8529 Fax: 505-345-6410 WEINSTEIN, RICHARD DPM Provider ID: NM025335 1925 JUAN TABO BLVD NE STE D, 87112 505-293-6290 Fax: 505-292-3014 Languages: Spanish WILLIAMS, DAVID DPM Provider ID: NM005C06 718 LOMAS BLVD NW , 87102 505-843-6464 Fax: 505-764-9210 WILLIAMSON, JONATHAN DPM Provider ID: NM005A63 4801 MCMAHON BLVD NW STE 110, 87114 505-872-3333 Fax: 505-880-1002 Languages: Portuguese WILLIAMSON, JONATHAN DPM Provider ID: NM005A63 5111 JUAN TABO BLVD NE , 87111 505-880-1000 Fax: 505-880-1002 Languages: Portuguese WREGE, STEVEN DPM Provider ID: NM015372 5111 JUAN TABO BLVD NE , 87111 505-271-9900 Fax: 505-271-0217 Preventive Medicine KESLER, DONECE MD Provider ID: NM014894 2211 LOMAS BLVD NE , 87131 505-272-4751 Pulmonary Diseases BELYAEV, STANISLAV MD Provider ID: NM003F35 500 WALTER ST NE STE 205, 87102 505-262-7223 Fax: 505-262-7450 Languages: Russian BOIVIN, MICHEL MD Provider ID: NM019411 2211 LOMAS BLVD NE , 87131 505-272-4661 BOXER, RICHARD MD Provider ID: NM029L39 8300 CONSTITUTION AVE NE , 87110 505-291-2700 Fax: 505-291-2989 Note: Provider is not contracted with BCBSNM for members residing in Bernalillo, Sandoval,Valencia and Torrance counties Languages: Spanish BRONITSKY, RONALD MD Provider ID: NM001L24 5901 HARPER DR , 87109 505-823-8870 Fax: 505-923-8875 Note: Provider is not contracted with BCBSNM for members residing in Bernalillo, Sandoval,Valencia and Torrance counties BRONITSKY, RONALD MD Provider ID: NM001L24 8300 CONSTITUTION AVE NE BLDG D, 87110 505-291-2100 Fax: 505-291-2102 Note: Provider is not contracted with BCBSNM for members residing in Bernalillo, Sandoval,Valencia and Torrance counties BROWN, LEE MD Provider ID: NM024740 1011 MEDICAL ARTS AVE NE BLDB 2, 87102 505-272-6110 BROWN, LEE MD Provider ID: NM024740 2211 LOMAS BLVD NE , 87131 505-272-3840 BUSBY, HELEN MD Provider ID: NM014757 2211 LOMAS BLVD NE , 87131 505-272-3840 CHANG, BETTY MD Provider ID: NM019E31 2211 LOMAS BLVD NE , 87131 505-272-3840 CROWELL, RICHARD MD Provider ID: NM029724 1201 CAMINO DE SALUD NE , 87106 505-272-4946 CROWELL, RICHARD MD Provider ID: NM013789 2211 LOMAS BLVD NE , 87131 505-272-4751 DORF, JEFFREY MD Provider ID: NM039636 4273 MONTGOMERY BLVD NE STE 200E, 87109 505-821-5992 GOITEIN, LARA MD Provider ID: NM004Y12 1100 CENTRAL AVE SE 4TH FLOOR STE B, 87106 505-841-1125 Fax: 505-841-1737 Note: Provider is not contracted with BCBSNM for members residing in Bernalillo, Sandoval,Valencia and Torrance counties GUIDO, PETER MD Provider ID: NM019H58 4700 JEFFERSON NE STE 800, 87109 505-872-6000 Fax: 505-872-6003 HARKINS, MICHELLE MD Provider ID: NM014858 2211 LOMAS BLVD NE , 87131 505-272-4751 IWANMOTO, GARY KEN MD Provider ID: NM013541 2211 LOMAS BLVD NE , 87131 505-272-1881 Albuquerque JENSEN, CRAIG MD Provider ID: NM001L44 1100 CENTRAL SE 4TH FLOOR STE B, 87106 505-724-6124 Fax: 505-724-6125 Note: Provider is not contracted with BCBSNM for members residing in Bernalillo, Sandoval,Valencia and Torrance counties MELENDRES GROVES, LANA MD Provider ID: NM005L75 2211 LOMAS BLVD NE 5TH FLR ACC, 87106 505-272-2273 MILLER, BRUCE MD Provider ID: NM003Z15 8300 CONSTITUTION NE , 87110 505-291-2700 Fax: 505-291-2989 Note: Provider is not contracted with BCBSNM for members residing in Bernalillo, Sandoval,Valencia and Torrance counties MONTOYA, MATTHEW MD Provider ID: NM003A13 1101 MEDICAL ARTS AVE NE BLDG 4, 87102 505-291-2100 Fax: 505-291-2196 Note: Provider is not contracted with BCBSNM for members residing in Bernalillo, Sandoval,Valencia and Torrance counties MONTOYA, MATTHEW MD Provider ID: NM003A13 8300 CONSTITUTION AVE NE BLDG D, 87110 505-291-2100 Fax: 505-291-2196 Note: Provider is not contracted with BCBSNM for members residing in Bernalillo, Sandoval,Valencia and Torrance counties MOSELEY, POPE MD Provider ID: NM013624 2211 LOMAS BLVD NE , 87131 505-272-1881 NAZON, DANIEL MD Provider ID: NM004N29 500 WALTER ST NE STE 205, 87102 505-262-7223 Fax: 505-262-7450 POLINER, JAMES MD Provider ID: NM003A27 1101 MEDICAL ARTS AVE NE BLDG 4, 87102 505-291-2100 Fax: 505-291-2196 Note: Provider is not contracted with BCBSNM for members residing in Bernalillo, Sandoval,Valencia and Torrance counties PORTER, DONALD MD Provider ID: NM003A28 1101 MEDICAL ARTS AVE NE BLDG 4, 87102 505-291-2100 Fax: 505-291-2196 Note: Provider is not contracted with BCBSNM for members residing in Bernalillo, Sandoval,Valencia and Torrance counties February 2012 79 Specialists
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Experience. Wellness. Everywhere. S
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Table of Contents Primary Care Prov
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Primary Care Providers HANUMANDLA,
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Primary Care Providers DERKSEN, DAN
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Primary Care Providers MCCOY, MEGAN
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Primary Care Providers STAPLETON, J
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Primary Care Providers YAMAMOTO, KE
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Primary Care Providers KULASINGHE,
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Primary Care Providers CONCENTRA UR
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Primary Care Providers PENTECOST, J
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Primary Care Providers WOSICK, LUAN
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Primary Care Providers Pediatrics C
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Primary Care Providers General Prac
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Primary Care Providers VEILLEUX, CA
Page 29 and 30: Primary Care Providers Grants Cibol
Page 31 and 32: Primary Care Providers ARMISTEAD, D
Page 33 and 34: Primary Care Providers SAAVEDRA, RA
Page 35 and 36: Primary Care Providers REHAB OCCUPA
Page 37 and 38: Primary Care Providers LAKE, ANNA M
Page 39 and 40: Primary Care Providers Penasco Taos
Page 41 and 42: Primary Care Providers Occupational
Page 43 and 44: Primary Care Providers KUMAR, KRISH
Page 45 and 46: Primary Care Providers SALAS, BARBA
Page 47 and 48: Primary Care Providers Silver City
Page 49 and 50: Primary Care Providers ENDRES, DELO
Page 51 and 52: Primary Care Providers Federally Qu
Page 53 and 54: Primary Care Providers LOVELESS, AL
Page 55 and 56: Specialists Trinidad Las Animas Cou
Page 57 and 58: Specialists BUJOI, MIHAELA MD Provi
Page 59 and 60: Specialists ZEMAN, HOWARD MD Provid
Page 61 and 62: Specialists MORGAN, ELIZABETH MD Pr
Page 63 and 64: Specialists COSTON, SEAN MD Provide
Page 65 and 66: Specialists Hand Surgery LARSEN, KE
Page 67 and 68: Specialists MELENDRES GROVES, LANA
Page 69 and 70: Specialists CRONIN, RICHARD MD Prov
Page 71 and 72: Specialists CLAPP, NADINE MD Provid
Page 73 and 74: Specialists STUART, KELLY MD Provid
Page 75 and 76: Specialists ARCHIBECK, MICHAEL MD P
Page 77 and 78: Specialists Pain Mgmt or Anesthesio
Page 79: Specialists LEDMAN, JUDY MD Provide
Page 83 and 84: Specialists CHAVEZ CHIANG, NATALIA
Page 85 and 86: Specialists General Surgery ANOUSHF
Page 87 and 88: Specialists Cerrillos Santa Fe Coun
Page 89 and 90: Specialists PAUL ANDERSON MD PA, Pr
Page 91 and 92: Specialists Internal Medicine HELD,
Page 93 and 94: Specialists SONG, MI KYOUNG MD Prov
Page 95 and 96: Specialists DAVENPORT, JENNIFER MD
Page 97 and 98: Specialists ROBERT G IVEY, Provider
Page 99 and 100: Specialists LOPEZ, STEVEN MD Provid
Page 101 and 102: Specialists SHERER, KEVIN MD Provid
Page 103 and 104: Specialists Los Alamos Los Alamos C
Page 105 and 106: Specialists Ojo Caliente Taos Count
Page 107 and 108: Specialists YATSKOWITZ, JEROME MD P
Page 109 and 110: Specialists BRADY, CHAD DPM Provide
Page 111 and 112: Specialists JACKSON, CHRISTOPHER MD
Page 113 and 114: Specialists PMS SANTA FE COMM GUIDA
Page 115 and 116: Specialists MANSKE, ERIC MD Provide
Page 117 and 118: Specialists Pulmonary Diseases AL D
Page 119 and 120: Specialists GRUBER, CHRISTOPER MD P
Page 121 and 122: Specialists ROCKWOOD, JASON DPM Pro
Page 123 and 124: Specialists Neurology MORENO, MIGUE
Page 125 and 126: Specialists WILMS, HENRIK MD Provid
Page 127 and 128: Specialists JOHNSON, CARSON MD Prov
Page 129 and 130: CO Cortez Montezuma County Durable
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Hospitals,Facilities, and Other Car
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NM ALBUQUERQUE Bernalillo County Ur
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ZIA HEALTH CENTER, Provider ID: 00N
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Davis Vision Providers Robison, Edw
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Davis Vision Providers Roland, Nath
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DentaQuest CHA, LILY DDS 111 COORS
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DentaQuest FORDE, COLIN DDS 1275 AN
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DentaQuest ESPANOLA NM RIO ARRIBA G
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DentaQuest 2141 HAMMERAND CT STE B
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DentaQuest CHAIKIN, RACHELLE DDS 64
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DentaQuest LIN, ROYANA DDS 7211 N M
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NM ALAMOGORDO Otero County KMART PH
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Pharmacy Network CUBA Sandoval Coun
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Pharmacy Network SANTA ROSA Guadalu
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NM Salud Alphabetical Index BAGGS,
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NM Salud Alphabetical Index CONNORS
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NM Salud Alphabetical Index GARARD,
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NM Salud Alphabetical Index JONES,
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NM Salud Alphabetical Index MASON,
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NM Salud Alphabetical Index PAVIA,
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NM Salud Alphabetical Index SANTA F
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NM Salud Alphabetical Index UNVERZA
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Acute Care Hospital ADVANCED CARE H
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NM Salud Providers by Specialty Ind
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February 2012 Primary Care Provider
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NM Salud Primary Care Providers by
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February 2012 Specialties by Locati
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NM Salud Specialties by Location In
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February 2012 Primary Care Provider
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NM Salud February 2012 Primary Care
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NM Salud LA CLINICA DE FAMILIA INC,
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NM Salud KNACKSTEDT, SHIRLEY CNP CN
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