NPIMap

Organization Active NPI

Oak Street Health Physicians Group of New Mexico LLC

  • Primary Care Clinic/Center
  • Albuquerque, NM
National Provider Identifier
1134793151
Registry record updated Oct 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
OAK STREET HEALTH PHYSICIANS GROUP OF NEW MEXICO LLC
Practice address
4208 Central Ave SW Ste G
Albuquerque, NM 87105-1695
Phone
(505) 777-3001
Fax
(505) 808-4977
NPI assigned
May 14, 2021
Last updated
Oct 13, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2025

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

Authorized official

Name
Dr. Terrance Morton, MD
Title
Cmo
Phone
(704) 607-4835

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X NU Primary
Nurse Practitioner 363L00000X NU
Family Nurse Practitioner 363LF0000X NU
Clinical Social Worker 1041C0700X NU
Family Medicine Physician 207Q00000X NU
Internal Medicine Physician 207R00000X NU

Addresses

Primary practice location

4208 Central Ave SW Ste G
Albuquerque, NM 87105-1695

Mailing address

PO Box 740018
Atlanta, GA 30374-0018
Phone (773) 352-1515

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210916000169 NM Part B Supplier - Clinic/Group Practice 4981001096 Receives reassigned benefits from 39 practitioners
Practice locations: Albuquerque, NM

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
32D2228150Oak Street Health4208 Central Ave SW, Suite G, Albuquerque, NM 87105Certificate of waiverJun 22, 2027

National Provider Directory

National Provider Directory

Locations

333 Montano Rd NW
Ste A1
Albuquerque, NM 87107
Phone (505) 355-1422

5555 Zuni Rd SE
Ste 11
Albuquerque, NM 87108
Phone (505) 280-6849

Practitioners & affiliated clinicians

Practitioners 42

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.

View all 42

NPI Registry JSON

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

{
    "created_epoch": "1620950400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1760313600000",
    "number": "1134793151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 740018",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303740018",
            "telephone_number": "773-352-1515",
            "fax_number": "312-929-0373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4208 CENTRAL AVE SW STE G",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871051695",
            "telephone_number": "505-777-3001",
            "fax_number": "505-808-4977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OAK STREET HEALTH PHYSICIANS GROUP OF NEW MEXICO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-14",
        "last_updated": "2025-10-13",
        "certification_date": "2025-10-13",
        "status": "A",
        "authorized_official_last_name": "MORTON",
        "authorized_official_first_name": "TERRANCE",
        "authorized_official_title_or_position": "CMO",
        "authorized_official_telephone_number": "704-607-4835",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "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 Oct 13, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.