Anusara Carolyn Ellen Ice, MD

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

License

RS2022-0556 Issued in NM

Practice address

Msc10 5610 1 University of New Mexico
Albuquerque, NM 87131-0001

Phone

(505) 272-4161

Fax

(505) 272-2776

NPI assigned

Apr 23, 2022

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1650672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756944000000",
    "number": "1093459356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "MSC10 5610 1 UNIVERSITY OF NEW MEXICO",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871310001",
            "telephone_number": "505-272-4161",
            "fax_number": "505-272-2776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MSC10 5610 1 UNIVERSITY OF NEW MEXICO",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871310001",
            "telephone_number": "505-272-4161",
            "fax_number": "505-272-2776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ICE",
        "first_name": "ANUSARA CAROLYN",
        "middle_name": "ELLEN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-04-23",
        "last_updated": "2025-09-04",
        "certification_date": "2025-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NM",
            "license": "RS2022-0556",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Student in an Organized Health Care Education/Training Program in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Student in an Organized Health Care Education/Training Program in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2025; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.