Samantha Marie Pacheco

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

58850 Issued in NM

Practice address

3901 Georgia St NE Ste A1
Albuquerque, NM 87110-1391

Phone

(505) 881-4012

NPI assigned

Jan 30, 2020

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• New Mexico Family Clinic LLC

  • Family Nurse Practitioner
  • Albuquerque, NM
  • NPI 1023366374
  NPD

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

{
    "created_epoch": "1580342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580342400000",
    "number": "1043841802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10405 SOLITUDE RD SW",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871215383",
            "telephone_number": "505-449-7024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3901 GEORGIA ST NE STE A1",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871101391",
            "telephone_number": "505-881-4012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PACHECO",
        "first_name": "SAMANTHA",
        "middle_name": "MARIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-01-30",
        "last_updated": "2020-01-30",
        "certification_date": "2020-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NM",
            "license": "58850",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "https://www.practicefusion.com/",
            "affiliation": "N",
            "address_1": "3901 Georgia St NE Ste A1",
            "city": "Albuquerque",
            "state": "NM",
            "country_code": "US",
            "postal_code": "871101391",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Peter David Pacheco, RPH., PA-C
• Philip Gerard Pacheco
• Romaine C Pacheco, BA
• Rosalinda Lucia Pacheco
• Samantha Pacheco
• Santiago Pacheco, MA
• Sara Marie Pacheco
• Sharon Sunny Pacheco, O.D.
• Sydney Pacheco
• Tami Pacheco, BA, MA, LADC

• Family Nurse Practitioner in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Family Nurse Practitioner in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.