Individual provider Active NPI

Carley Hernandez, OT

  • Occupational Therapist
  • Albuquerque, NM
National Provider Identifier
1043049992
Registry record updated Sep 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT-2023-0139 Issued in NM
Practice address
4250 Coors Blvd SW Ste C
Albuquerque, NM 87121-5500
Phone
(505) 727-4961
NPI assigned
Jul 30, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OT-2023-0139 NM Primary

Addresses

Primary practice location

4250 Coors Blvd SW Ste C
Albuquerque, NM 87121-5500

Mailing address

505 Elm St NE
Albuquerque, NM 87102-2500
Phone (505) 727-4725

Other practice location 1

505 Elm St NE
Albuquerque, NM 87102-2500
Phone (505) 727-4725

Other identifiers 1

IdentifierTypeStateIssuer
OT-2023-0139OtherNMNM LICENSE

Other names 1

  • Carley Medina Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240820003224 NM Practitioner - Occupational Therapist in Private Practice 4183162241 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
University of New Mexico School of Medicine, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Balanced Physical Therapy and Wellness LLCGroup PAC ID 9032427513, 50 clinicians

Practice addresses (Care Compare)

7849 Tramway Blvd NE
Albuquerque, NM 87122-2529

8010 Palomas Ave NE
Suite C
Albuquerque, NM 87109-5201
Phone (505) 208-7551

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OT-2023-0139NMMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Lovelace Unm Rehabilitation Hospital, LLC CurrentSince Sep 1, 2024 Accepting new patients
Lovelace Unm Rehabilitation Hospital LLC Current Accepting new patients
Balanced Physical Therapy and Wellness, LLC CurrentSince Sep 1, 2025 Accepting new patients
Lovelace Unm Rehabilitation Hospital LLC Occupational Therapist CurrentSince Sep 1, 2024 Accepting new patients

Locations

4250 Coors Blvd SW
Ste C
Albuquerque, NM 87121
Phone (505) 727-4725

505 Elm St NE
Albuquerque, NM 87102
Phone (505) 727-4700

7849 Tramway Blvd NE
Ste A
Albuquerque, NM 87122
Phone (505) 821-3831

4101 Indian School Rd NE
Ste 110
Albuquerque, NM 87110
Phone (505) 727-8360

111 Rio Rancho Blvd SE
#110
Rio Rancho, NM 87124
Phone (505) 727-4950

Organizations & group practices 4

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": "1722297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757894400000",
    "number": "1043049992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 ELM ST NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871022500",
            "telephone_number": "505-727-4725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4250 COORS BLVD SW STE C",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871215500",
            "telephone_number": "505-727-4961"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "505 Elm St NE",
            "address_purpose": "LOCATION",
            "city": "Albuquerque",
            "state": "NM",
            "postal_code": "871022500",
            "country_code": "US",
            "telephone_number": "505-727-4725",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HERNANDEZ",
        "first_name": "CARLEY",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-30",
        "last_updated": "2025-09-15",
        "certification_date": "2025-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NM",
            "license": "OT-2023-0139",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NM LICENSE",
            "identifier": "OT-2023-0139",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CARLEY",
            "last_name": "MEDINA",
            "credential": "OT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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 Sep 15, 2025; 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.