Active NPI
Melanie M Ukanwa, MD
- Family Medicine Physician
- Albuquerque, NM
National Provider Identifier
1114969896
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- MD20060291
- Practice address
- 4253 Montgomery Blvd NE Ste 220
Albuquerque, NM 87109-1130 - Phone
- (505) 881-5307
- Fax
- (505) 908-3816
- NPI assigned
- Jun 10, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | MD20060291 | NM | Primary |
| Addiction Medicine (Family Medicine) Physician | 207QA0401X | MD20060291 | NM |
Addresses
Primary practice location
4253 Montgomery Blvd NE Ste 220
Albuquerque, NM 87109-1130
Mailing address
PO Box 27453
Albuquerque, NM 87125-7453
Phone (505) 881-5307
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| NMAAA2194 | Other | MEDICARE PTAN | |
| 17670721 | Medicaid | NM |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Jul 1, 2022 through Jul 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD20060291 | NM | MD | Addiction Medicine (Family Medicine) Physician |
Interoperability endpoints
- mukanwa0@yourcarecommunity.org
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149897600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1761264000000",
"number": "1114969896",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 27453",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871257453",
"telephone_number": "505-881-5307",
"fax_number": "505-908-3816"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4253 MONTGOMERY BLVD NE STE 220",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871091130",
"telephone_number": "505-881-5307",
"fax_number": "505-908-3816"
}
],
"practiceLocations": [],
"basic": {
"last_name": "UKANWA",
"first_name": "MELANIE",
"middle_name": "M",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-10",
"last_updated": "2025-10-24",
"certification_date": "2025-10-24",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "NM",
"license": "MD20060291",
"primary": true
},
{
"code": "207QA0401X",
"taxonomy_group": "",
"desc": "Family Medicine, Addiction Medicine",
"state": "NM",
"license": "MD20060291",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE PTAN",
"identifier": "NMAAA2194",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "17670721",
"state": "NM"
}
],
"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 Oct 24, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.