Individual provider Active NPI

Sara A Mills, M.D.

  • Specialist
  • Albuquerque, NM
National Provider Identifier
1003831595
Registry record updated Apr 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
94-336 Issued in NM
Practice address
10151 Montgomery Blvd NE BLDG 1
Suite a
Albuquerque, NM 87111-3670
Phone
(505) 855-5503
Fax
(505) 855-5533
NPI assigned
Jul 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 94-336 NM Primary

Addresses

Primary practice location

10151 Montgomery Blvd NE BLDG 1
Suite a
Albuquerque, NM 87111-3670

Mailing address

10151 Montgomery Blvd NE BLDG 1
Suite a
Albuquerque, NM 87111-3670
Phone (505) 855-5503

Other identifiers 2

IdentifierTypeStateIssuer
20989MedicaidNM
NM013368OtherNMBCBS OF NM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080206000252 NM Practitioner - Dermatology 6002999661 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
94-336NMMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Rio Grande Dermatology, PC CurrentSince Mar 31, 2019 Accepting new patients
Epiphany Dermatology of New Mexico, LLC PastSince Mar 1, 2017 Accepting new patients
Dermatology Consultants of Albuquerque PC Past Accepting new patients

Locations

4545 Alameda Blvd NE
Ste G
Albuquerque, NM 87113
Phone (505) 896-2900

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1208649600000",
    "number": "1003831595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10151 MONTGOMERY BLVD NE BLDG 1",
            "address_2": "SUITE A",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871113670",
            "telephone_number": "505-855-5503",
            "fax_number": "505-855-5533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10151 MONTGOMERY BLVD NE BLDG 1",
            "address_2": "SUITE A",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871113670",
            "telephone_number": "505-855-5503",
            "fax_number": "505-855-5533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLS",
        "first_name": "SARA",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-13",
        "last_updated": "2008-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NM",
            "license": "94-336",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "20989",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF NM",
            "identifier": "NM013368",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.