Individual provider Active NPI

Anastasiia Neelagaru, M.D.

  • Adult Medicine Physician
  • Albuquerque, NM
National Provider Identifier
1114284445
Registry record updated Jun 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Medicine PhysicianTaxonomy code 207QA0505X
License
MD2022-0189 Issued in NM
Practice address
11311 Menaul Blvd NE Ste D
Albuquerque, NM 87112-0008
Phone
(505) 305-7766
Fax
(505) 545-4141
NPI assigned
Apr 11, 2012
Reactivated
Oct 14, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Medicine Physician 207QA0505X MD2022-0189 NM Primary

Addresses

Primary practice location

11311 Menaul Blvd NE Ste D
Albuquerque, NM 87112-0008

Mailing address

11311 Menaul Blvd NE Ste D
Albuquerque, NM 87112-0008
Phone (505) 305-7766

Other practice location 1

11311 Menaul Blvd NE Ste D
Albuquerque, NM 87112-0008
Phone (505) 600-1119

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, NM2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20170124001459 TX Practitioner - Family PracticePractitioner - Geriatric Medicine 5496037608 Reassigns benefits to 1 organization
I20220503002264 NM Practitioner - Family Practice 5496037608 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Nitovo Healthcare LLCGroup PAC ID 6002277019, 2 clinicians

Practice addresses (Care Compare)

11311 Menaul Blvd NE
Albuquerque, NM 87112-0008
Phone (505) 305-7766

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD2022-0189NMMDAdult Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Optumcare New Mexico LLC CurrentSince May 9, 2022 Accepting new patients
Nitovo Healthcare LLC CurrentSince Aug 1, 2023 Accepting new patients
Optumcare Endoscopy Center New Mexico, LLC Past Accepting new patients
Comprehensive Interventional Care Centers, PLLC Past Accepting new patients

Locations

11311 Menaul Blvd NE
Ste D
Albuquerque, NM 87112
Phone (505) 305-7766

2121 Juan Tabo Blvd NE
Albuquerque, NM 87112
Phone (505) 237-8800

5150 Journal Center Blvd NE
Fl 3
Albuquerque, NM 87109
Phone (505) 262-3212

11311 Menaul Blvd NE
Albuquerque, NM 87112
Phone (505) 305-7766

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

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": "1334102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780444800000",
    "number": "1114284445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11311 MENAUL BLVD NE STE D",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871120008",
            "telephone_number": "505-305-7766",
            "fax_number": "505-545-4141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11311 MENAUL BLVD NE STE D",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871120008",
            "telephone_number": "505-305-7766",
            "fax_number": "505-545-4141"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11311 Menaul Blvd NE Ste D",
            "address_purpose": "LOCATION",
            "city": "Albuquerque",
            "state": "NM",
            "postal_code": "871120008",
            "country_code": "US",
            "telephone_number": "505-600-1119",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NEELAGARU",
        "first_name": "ANASTASIIA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-11",
        "last_updated": "2026-06-03",
        "certification_date": "2026-06-03",
        "deactivation_date": "2020-07-22",
        "reactivation_date": "2020-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "NM",
            "license": "MD2022-0189",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.