Sally Bachofer
Individual provider Active NPI Family Medicine Physician · Albuquerque, NM
NPI 1164578951 · NPPES record last updated Mar 22, 2017
Key facts
- NPI
- 1164578951
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 83-154 (NM)
- Practice address
- 2400 Tucker NE
MSC 09-5040 1 University of New Mexico (FPC)
Albuquerque, NM 87131-0001 - Phone
- (505) 272-1734
- Fax
- (505) 272-6308
- NPI assigned
- Jan 26, 2007
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NM
- Eligible to order & refer
- Part B services: No · DME: Yes · Home health: No · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20071010000165 | NM | Practitioner - Family Practice | 3779679527 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Unm Medical Group Inc | Current |
Accepting new patients | |
| Unm Medical Group, Inc. | Current |
Accepting new patients | |
| Unm Medical Group Inc | Past | Accepting new patients |
Locations
933 Bradbury Dr SE
Ste 2222
Albuquerque, NM 87106
Phone (505) 272-1476
1201 Camino de Salud NE
Albuquerque, NM 87102
Phone (505) 272-4443
2211 Lomas Blvd NE
Unm, NM 87106
Phone (505) 272-1111
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 83-154 | NM | Yes |
Addresses
Primary practice location
2400 Tucker NE
MSC 09-5040 1 University of New Mexico (FPC)
Albuquerque, NM 87131-0001
Mailing address
933 Bradbury Dr SE
Suite 2222
Albuquerque, NM 87106-4374
Phone (505) 272-3120
Other providers in Albuquerque, NM
- Bachicha and Sterba Dental, PA
- Angela Elizabeth Bachicha
- Charlene Bachicha
- Christina Maria Bachicha
- Jose Bachicha
- Amy Michelle Bachyrycz
- Back to Health Clinic Limited
- Joanna Lynn Back
- Backbone Family Chiropractic
- Alisha M Bacoccini
All providers in Albuquerque, NM · Family Medicine Physician in New Mexico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 22, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.