Individual provider Active NPI

Melody Dawn Krech, PT

  • Physical Therapist
  • Albuquerque, NM
National Provider Identifier
1003982323
Registry record updated Apr 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1251 Issued in NM
Practice address
5130 San Francisco Rd NE
Ste B
Albuquerque, NM 87109-4618
Phone
(505) 823-2411
Fax
(505) 858-0650
NPI assigned
Nov 28, 2006
Last updated
Apr 10, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 1251 NM Primary

Addresses

Primary practice location

5130 San Francisco Rd NE
Ste B
Albuquerque, NM 87109-4618

Mailing address

6100 Seagull St NE
Suite B-102
Albuquerque, NM 87109-2500
Phone (505) 823-2411

Other identifiers 4

IdentifierTypeStateIssuer
26790OtherNMPRESBYTERIAN HEALTH PLAN
NM00Q304OtherNMBCBS
188126500OtherNMACS
695957OtherNMACN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120620000062 NM Practitioner - Physical Therapist in Private Practice 2365430220 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rainbows Promise Therapies IncGroup PAC ID 9931197894, 2 clinicians

Practice addresses (Care Compare)

5130 San Francisco Rd NE
Suite B
Albuquerque, NM 87109-4618
Phone (505) 823-2411

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1251NMMDPeer Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Rainbow's Promise Therapies, Inc. Physical Therapist CurrentSince May 7, 1999 Accepting new patients

Locations

5130 San Francisco Rd NE
Ste B
Albuquerque, NM 87109
Phone (505) 823-2411

6100 Seagull St NE
Ste 102
Albuquerque, NM 87109
Phone (505) 823-2411

6100 Seagull St NE
Ste B102
Albuquerque, NM 87109
Phone (505) 823-2411

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1164672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554854400000",
    "number": "1003982323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6100 SEAGULL ST NE",
            "address_2": "SUITE B-102",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871092500",
            "telephone_number": "505-823-2411",
            "fax_number": "505-858-0650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5130 SAN FRANCISCO RD NE",
            "address_2": "STE B",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871094618",
            "telephone_number": "505-823-2411",
            "fax_number": "505-858-0650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRECH",
        "first_name": "MELODY",
        "middle_name": "DAWN",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-28",
        "last_updated": "2019-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NM",
            "license": "1251",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRESBYTERIAN HEALTH PLAN",
            "identifier": "26790",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "NM00Q304",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ACS",
            "identifier": "188126500",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ACN",
            "identifier": "695957",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.