Alyssa Briana Mirabal, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD2023-0130 Issued in NM

Practice address

1851 Old US 66
Edgewood, NM 87015-7200

Phone

(505) 286-2396

Fax

(505) 272-8045

NPI assigned

Apr 8, 2019

Last updated

Jul 27, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

General Practice

Education

University of New Mexico School of Medicine, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

McLeod Medical Centers of NM IncGroup PAC ID 5092075531, 54 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: alyssa.mirabal.1@27050.direct.athenahealth.com
• Direct secure messaging: amirabal197828@christushealth.direct-ci.net

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.

• McLeod Medical Centers of NM, Inc.

  dba Duke City Primary Care

  • Family Medicine Physician
  • Cedar Crest, NM
  • NPI 1700393782
  Medicare reassignment Care Compare group NPD
• McLeod Medical Centers of NM, Inc.

  dba Duke City Primary Care

  • Family Medicine Physician
  • Cedar Crest, NM
  • NPI 1215580832
  NPD

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

{
    "created_epoch": "1554681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690416000000",
    "number": "1043773005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1851 OLD US 66",
            "city": "EDGEWOOD",
            "state": "NM",
            "postal_code": "870157200",
            "telephone_number": "505-286-2396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1851 OLD US 66",
            "city": "EDGEWOOD",
            "state": "NM",
            "postal_code": "870157200",
            "telephone_number": "505-286-2396",
            "fax_number": "505-272-8045"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11501 Montgomery Blvd NE",
            "address_purpose": "LOCATION",
            "city": "Albuquerque",
            "state": "NM",
            "postal_code": "871112796",
            "country_code": "US",
            "telephone_number": "505-814-1333",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MIRABAL",
        "first_name": "ALYSSA",
        "middle_name": "BRIANA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-04-08",
        "last_updated": "2023-07-27",
        "certification_date": "2023-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NM",
            "license": "MD2023-0130",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Harry Schnee Messec, MD
• Jennifer Lee Mettling
• Sharon Louise Meyer, LMSW
• Michael Lysonski DDS LLC (Edgewood Dental)
• Neita Anne Miller, MS/CCC-SLP
• Molly McEachen LCSW LLC
• Kimberly Mondragon
• Jessica Monique Montez
• Ann Losee Morgan, D.O.M.
• Adamatta Mudada, PHARMD

• Family Medicine Physician in Edgewood, NM
• Providers in Edgewood, NM by specialty
• Family Medicine Physician in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.