Individual provider Active NPI

Ray Kelley, MD

  • Family Medicine Physician
  • Albuquerque, NM
National Provider Identifier
1104455328
Registry record updated Aug 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD2023-1365 Issued in NM
Practice address
1 Sagebrush St SW
Albuquerque, NM 87105-3942
Phone
(505) 869-3200
Fax
(505) 869-4088
NPI assigned
Apr 8, 2020
Last updated
Aug 6, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD2023-1365 NM Primary

Addresses

Primary practice location

1 Sagebrush St SW
Albuquerque, NM 87105-3942

Mailing address

1 Sagebrush St SW
Albuquerque, NM 87105-3942
Phone (505) 869-3200

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240209002020 NM Practitioner - Family Practice 2062838048 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of California, San Francisco School of Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Pueblo of IsletaGroup PAC ID 9739080631, 13 clinicians

Practice addresses (Care Compare)

1 Sagebrush St SW
Albuquerque, NM 87105-3942
Phone (505) 869-4463

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Pueblo of Isleta CurrentSince Jan 7, 2024 Accepting new patients
Pueblo of Isleta CurrentSince Jan 7, 2024 Accepting new patients
Pueblo of Isleta Past Accepting new patients
Pueblo of Isleta Past Accepting new patients

Locations

1 Sagebrush St SW
Albuquerque, NM 87105
Phone (505) 869-4463

Organizations & group practices 4

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1586304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785974400000",
    "number": "1104455328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 SAGEBRUSH ST SW",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871053942",
            "telephone_number": "505-869-3200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 SAGEBRUSH ST SW",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871053942",
            "telephone_number": "505-869-3200",
            "fax_number": "505-869-4088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLEY",
        "first_name": "RAY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-08",
        "last_updated": "2026-08-06",
        "certification_date": "2026-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NM",
            "license": "MD2023-1365",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.