Individual provider Active NPI

Quan Ky DO

  • Physician Assistant
  • Albuquerque, NM
National Provider Identifier
1154926160
Registry record updated Mar 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA2025-0157 Issued in NM
Practice address
5600 Eubank Blvd NE Ste 110
Albuquerque, NM 87111-1519
Phone
(505) 880-1920
NPI assigned
Nov 30, 2020
Last updated
Mar 2, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 2, 2026

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 PA2025-0157 NM Primary

Addresses

Primary practice location

5600 Eubank Blvd NE Ste 110
Albuquerque, NM 87111-1519

Mailing address

5600 Eubank Blvd NE Ste 110
Albuquerque, NM 87111-1519
Phone (505) 880-1920

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
I20260219002090 NM Practitioner - Physician Assistant 8921588708 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

7300 Ranch Rd
2222 Suite 200
Austin, TX 78730

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA2025-0157NMMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Epiphany Dermatology of New Mexico, LLC Single Specialty CurrentSince Jan 1, 2026 Accepting new patients

Locations

5600 Eubank Blvd NE
Ste 110
Albuquerque, NM 87111
Phone (505) 292-5850

5 Calle Medico
Ste A
Santa Fe, NM 87505
Phone (505) 557-6300

7300 Ranch Road 2222
Ste 200
Austin, TX 78730

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1606694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772409600000",
    "number": "1154926160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5600 EUBANK BLVD NE STE 110",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871111519",
            "telephone_number": "505-880-1920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5600 EUBANK BLVD NE STE 110",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871111519",
            "telephone_number": "505-880-1920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DO",
        "first_name": "QUAN",
        "middle_name": "KY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-11-30",
        "last_updated": "2026-03-02",
        "certification_date": "2026-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NM",
            "license": "PA2025-0157",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.