Individual provider Active NPI

Christina N Doucette, PA-C

  • Physician Assistant
  • Albuquerque, NM
National Provider Identifier
1114903499
Registry record updated Jun 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA2004-0047 Issued in NM
Practice address
1209 University Blvd NE
Albuquerque, NM 87102-1727
Phone
(505) 272-1502
Fax
(505) 272-1504
NPI assigned
Dec 19, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA2004-0047 NM Primary

Addresses

Primary practice location

1209 University Blvd NE
Albuquerque, NM 87102-1727

Mailing address

933 Bradbury Dr SE
Suite 2222
Albuquerque, NM 87106-4374
Phone (505) 272-3120

Other identifiers 1

IdentifierTypeStateIssuer
02226316MedicaidNM

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address UNMH@direct.health.unm.edu

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050321000692 NM Practitioner - Physician Assistant 8325099724 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Unm HospitalGroup PAC ID 7618889528, 394 clinicians

Practice addresses (Care Compare)

2211 Lomas Blvd NE
Albuquerque, NM 87106-2719
Phone (505) 272-2644

Merit-based Incentive Payment System (MIPS)

Final score
91.83 of 100Reported as group
Quality
83.58
Promoting interoperability
100
Improvement activities
40
Cost
72.52

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA2004-0047NMMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Unm Hospital CurrentSince Jan 13, 2005 Accepting new patients

Locations

933 Bradbury Dr SE
Ste 2222
Albuquerque, NM 87106
Phone (505) 272-1476

1209 University Blvd NE
Albuquerque, NM 87102
Phone (505) 272-4400

2211 Lomas Blvd NE
Unm, NM 87106
Phone (505) 272-1111

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.

NPI Registry JSON

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

{
    "created_epoch": "1134950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686182400000",
    "number": "1114903499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "933 BRADBURY DR SE",
            "address_2": "SUITE 2222",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871064374",
            "telephone_number": "505-272-3120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1209 UNIVERSITY BLVD NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871021727",
            "telephone_number": "505-272-1502",
            "fax_number": "505-272-1504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUCETTE",
        "first_name": "CHRISTINA",
        "middle_name": "N",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-19",
        "last_updated": "2023-06-08",
        "certification_date": "2023-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NM",
            "license": "PA2004-0047",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02226316",
            "state": "NM"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "UNMH@direct.health.unm.edu",
            "affiliation": "N",
            "address_1": "2211 Lomas Blvd NE",
            "city": "Albuquerque",
            "state": "NM",
            "country_code": "US",
            "postal_code": "871062719",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.