Organization Active NPI

Sandia Healthcare Group LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Albuquerque, NM
National Provider Identifier
1104636158
Registry record updated Jul 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
SANDIA HEALTHCARE GROUP LLC
Practice address
7000 Jefferson St NE
Albuquerque, NM 87109-4313
Phone
(505) 226-2741
Fax
(505) 631-0633
NPI assigned
Jan 11, 2025
Last updated
Jul 3, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2026

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

Authorized official

Name
Veronica Gabaldon
Title
Manager
Phone
(505) 226-2741

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

7000 Jefferson St NE
Albuquerque, NM 87109-4313

Mailing address

3301 Coors Blvd NW Ste R230
Albuquerque, NM 87120-1292
Phone (505) 226-2741

Other practice location 1

505 Elm St NE
Albuquerque, NM 87102-2500
Phone (505) 226-2741

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250318002586 NM Part B Supplier - Clinic/Group Practice 2860914942 Receives reassigned benefits from 2 practitioners
Practice locations: Albuquerque, NM

National Provider Directory

National Provider Directory

Locations

3301 Coors Blvd NW
Ste R230
Albuquerque, NM 87120

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1736553600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1783036800000",
    "number": "1104636158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3301 COORS BLVD NW STE R230",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871201292",
            "telephone_number": "505-226-2741",
            "fax_number": "505-631-0633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7000 JEFFERSON ST NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871094313",
            "telephone_number": "505-226-2741",
            "fax_number": "505-631-0633"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "505 Elm St NE",
            "address_purpose": "LOCATION",
            "city": "Albuquerque",
            "state": "NM",
            "postal_code": "871022500",
            "country_code": "US",
            "telephone_number": "505-226-2741",
            "fax_number": "505-631-0633",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SANDIA HEALTHCARE GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-01-11",
        "last_updated": "2026-07-03",
        "certification_date": "2026-07-03",
        "status": "A",
        "authorized_official_last_name": "GABALDON",
        "authorized_official_first_name": "VERONICA",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "505-226-2741"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2026; 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.