NPIMap

Organization Active NPI

Medical Associates of Northern New Mexico

  • Cardiovascular Disease Physician
  • Los Alamos, NM
National Provider Identifier
1073501508
Registry record updated Dec 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
Legal business name
MEDICAL ASSOCIATES OF NORTHERN NEW MEXICO
Practice address
3917 West Rd
Suite a
Los Alamos, NM 87544-2275
Phone
(505) 661-8900
Fax
(505) 661-8961
NPI assigned
Oct 10, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2022

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

Authorized official

Name
Dr. Ann Carolyn Linnebur, M.D.NPI 1043273543
Title
President
Phone
(505) 661-8900

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X
Cardiovascular Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RC0000X Primary

Addresses

Primary practice location

3917 West Rd
Suite a
Los Alamos, NM 87544-2275

Mailing address

3917 West Rd
Suite a
Los Alamos, NM 87544-2275
Phone (505) 661-8900

Other identifiers 1

IdentifierTypeStateIssuer
H3807MedicaidNM

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040407000155 NM Part B Supplier - Clinic/Group Practice 1557354339 Receives reassigned benefits from 14 practitioners
1 other NPI on this enrollment
Practice locations: Los Alamos, NM

National Provider Directory

National Provider Directory

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/AAGADA

Practitioners & affiliated clinicians

Practitioners 27

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 27

NPI Registry JSON

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

{
    "created_epoch": "1128902400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1670284800000",
    "number": "1073501508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3917 WEST RD",
            "address_2": "SUITE A",
            "city": "LOS ALAMOS",
            "state": "NM",
            "postal_code": "875442275",
            "telephone_number": "505-661-8900",
            "fax_number": "505-661-8961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3917 WEST RD",
            "address_2": "SUITE A",
            "city": "LOS ALAMOS",
            "state": "NM",
            "postal_code": "875442275",
            "telephone_number": "505-661-8900",
            "fax_number": "505-661-8961"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL ASSOCIATES OF NORTHERN NEW MEXICO",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-10",
        "last_updated": "2022-12-06",
        "certification_date": "2022-12-06",
        "status": "A",
        "authorized_official_last_name": "LINNEBUR",
        "authorized_official_first_name": "ANN",
        "authorized_official_middle_name": "CAROLYN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "505-661-8900",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "H3807",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Alamos, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.