Mr Sid Mosiman, PT | |
604 S Rio Grande Ave, Aztec, NM 87410-2260 | |
(505) 334-9616 | |
(505) 334-7343 |
Full Name | Mr Sid Mosiman |
---|---|
Gender | Male |
Speciality | Physical Therapy |
Experience | 51 Years |
Location | 604 S Rio Grande Ave, Aztec, New Mexico |
Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1871667089 | NPI | - | NPPES |
K0972 | Medicaid | NM |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
225100000X | Physical Therapist | 1025 (New Mexico) | Primary |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Physical Therapy And Sports Medicine Of Northern New Mexico, Inc. | 1951401785 | 2 |
Provider Name | Physical Therapy & Sports Medicine Of Northern New Mexico, Inc. |
---|---|
Provider Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
Provider Identifiers | NPI Number: 1306069224 PECOS PAC ID: 1951401785 Enrollment ID: O20070710000300 |
Mailing Address | Practice Location Address |
---|---|
Mr Sid Mosiman, PT 604 S Rio Grande Ave, Aztec, NM 87410-2260 Ph: (505) 334-9616 | Mr Sid Mosiman, PT 604 S Rio Grande Ave, Aztec, NM 87410-2260 Ph: (505) 334-9616 |
Margaret Irene Gores, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 505 N Main Ave, Aztec, NM 87410 Phone: 505-334-9616 Fax: 505-334-7343 | |
Physical Therapy & Sports Medicine Of Northern New Mexico, Inc. Physical Therapist Medicare: Medicare Enrolled Practice Location: 505 N Main Ave, Aztec, NM 87410 Phone: 505-334-9616 Fax: 505-334-7343 | |
Gordon Henriksen, Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1607 W Aztec Blvd, Aztec, NM 87410 Phone: 505-334-3695 | |
Matthew Vidal Fernandez, PT Physical Therapist Medicare: Medicare Enrolled Practice Location: 505 N Main Ave, Aztec, NM 87410 Phone: 505-334-9616 |