Individual provider Active NPI

Alexan Isahag Yerevanian, M.D.

  • Neurology Physician
  • Albuquerque, NM
National Provider Identifier
1114301637
Registry record updated May 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
MD2024-1097 Issued in NM
Practice address
500 Walter St NE Ste 401
Albuquerque, NM 87102-2563
Phone
(505) 727-7833
NPI assigned
Jul 14, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Neuromuscular Medicine (Psychiatry & Neurology) Physician 2084N0008X A143798 CA
Neurology Physician 2084N0400X 143798 CA
Student in an Organized Health Care Education/Training Program 390200000X
Neurology Physician 2084N0400X MD2024-1097 NM Primary

Addresses

Primary practice location

500 Walter St NE Ste 401
Albuquerque, NM 87102-2563

Mailing address

4101 Indian School Rd NE Ste 110
Albuquerque, NM 87110-3991

Other practice location 1

200 W Arbor Dr
San Diego, CA 92103-9000
Phone (619) 543-6222

Other practice location 2

1801 Wilshire Blvd Ste 100
Santa Monica, CA 90403-5609
Phone (310) 319-5098

Other identifiers 1

IdentifierTypeStateIssuer
MD2024-1097OtherNMSTATE LICENSE

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
I20250131000862 NM Practitioner - Neurology 1355772757 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Southwest Medical Associates, LLCGroup PAC ID 7214831114, 326 clinicians

Practice addresses (Care Compare)

500 Walter St NE
Suite 401
Albuquerque, NM 87102-2563
Phone (505) 727-5910

Hospital & facility affiliations

  • Lovelace Women'S Hospital Hospital, Albuquerque, NM, CCN 320017
  • Lovelace Westside Hospital Hospital, Albuquerque, NM, CCN 320074
  • Lovelace Medical Center Hospital, Albuquerque, NM, CCN 320009
  • Ronald Reagan UCLA Medical Center Hospital, Los Angeles, CA, CCN 050262
  • Santa Monica - UCLA Med Ctr & Orthopaedic Hospital Hospital, Santa Monica, CA, CCN 050112
  • Lovelace Unm Rehabilitation Hospital Inpatient rehabilitation facility, Albuquerque, NM, CCN 323028

Merit-based Incentive Payment System (MIPS)

Final score
87.46 of 100Reported as group
Quality
80.82
Promoting interoperability
100
Improvement activities
40
Cost
71.93

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A143798CAMDNeuromuscular Medicine (Psychiatry & Neurology) Physician
143798CAMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southwest Medical Associates, LLC CurrentSince Jan 20, 2025 Accepting new patients
Southwest Medical Associates, LLC CurrentSince Jan 20, 2025 Accepting new patients

Locations

715 Martin Luther King Ave NE
Ste 301
Albuquerque, NM 87102
Phone (505) 727-4500

500 Walter St NE
Ste 401
Albuquerque, NM 87102
Phone (505) 727-5910

4101 Indian School Rd NE
Ste 110
Albuquerque, NM 87110
Phone (505) 727-8360

Interoperability endpoints

  • Direct secure messaging: ayerevanian1336231@ahs.direct-ci.com

Organizations & group practices 2

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 6

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": "1436832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747785600000",
    "number": "1114301637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4101 INDIAN SCHOOL RD NE STE 110",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871103991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 WALTER ST NE STE 401",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871022563",
            "telephone_number": "505-727-7833"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 W Arbor Dr",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921039000",
            "country_code": "US",
            "telephone_number": "619-543-6222",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1801 Wilshire Blvd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Santa Monica",
            "state": "CA",
            "postal_code": "904035609",
            "country_code": "US",
            "telephone_number": "310-319-5098",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YEREVANIAN",
        "first_name": "ALEXAN",
        "middle_name": "ISAHAG",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-07-14",
        "last_updated": "2025-05-21",
        "certification_date": "2025-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0008X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neuromuscular Medicine",
            "state": "CA",
            "license": "A143798",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "CA",
            "license": "143798",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NM",
            "license": "MD2024-1097",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "MD2024-1097",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.