Individual provider Active NPI

Vincent Muller, PHYSICIAN ASSISTANT

  • Physician Assistant
  • Socorro, NM
National Provider Identifier
1053412692
Registry record updated Sep 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
200 Neel Ave
Socorro, NM 87801-4649
Phone
(575) 835-2940
Fax
(575) 835-2216
NPI assigned
Sep 26, 2006
Last updated
Sep 9, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NU Primary

Addresses

Primary practice location

200 Neel Ave
Socorro, NM 87801-4649

Mailing address

200 Neel Ave
Socorro, NM 87801-4649
Phone (575) 835-2940

Other identifiers 1

IdentifierTypeStateIssuer
75000351MedicaidNM

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120822000685 NM Practitioner - Physician Assistant 7911154109 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
New Mexico Heart Institute, LLC Past Accepting new patients

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, 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": "1159228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1441756800000",
    "number": "1053412692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 NEEL AVE",
            "city": "SOCORRO",
            "state": "NM",
            "postal_code": "878014649",
            "telephone_number": "575-835-2940",
            "fax_number": "575-835-2216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 NEEL AVE",
            "city": "SOCORRO",
            "state": "NM",
            "postal_code": "878014649",
            "telephone_number": "575-835-2940",
            "fax_number": "575-835-2216"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULLER",
        "first_name": "VINCENT",
        "name_prefix": "Mr.",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-26",
        "last_updated": "2015-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "75000351",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Socorro, NM

Sources for this page

Verify at the official NPI Registry.