Pangea Medical LLC
Psychiatry & Neurology, Psychiatry in Roswell, NM. Organization (NPI-2).
Details
- NPI
- 1255786703
- Entity type
- Organization (NPI-2)
- Legal business name
- Pangea Medical LLC
- Organization subpart
- No
- Enumeration date
- May 3, 2016
- Certification date
- Oct 21, 2022
- Last updated
- Oct 21, 2022
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PART B SUPPLIER - CLINIC/GROUP PRACTICE
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology, Psychiatry | MD2011-0547 | NM | Yes |
| 207R00000X | Internal Medicine | MD2011-0547 | NM |
Other names
- Pangea Medical (Doing Business As)
Practice location
405 W Country Club RdRoswell, NM 88201-5209
Phone 575-624-2095 · Fax 575-208-0780
Mailing address
Po Box 8244Roswell, NM 88202-8244
Phone 575-624-2095 · Fax 575-208-0780
Authorized official
Steven R Black
Managing Member
5756242095
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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All 9 Psychiatry Physician providers in Roswell · All 1,414 providers in Roswell
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