Sandra Addari
Individual provider Active NPI Family Medicine Physician · Las Cruces, NM
NPI 1174635791 · NPPES record last updated Sep 16, 2016
Key facts
- NPI
- 1174635791
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- MD2006-0554 (NM)
- Practice address
- 2465 S Telshor Blvd
Las Cruces, NM 88011-5049 - Phone
- (505) 532-6061
- Fax
- (505) 532-6063
- NPI assigned
- Aug 31, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160926000929 | TX | Order and Referring Only - Family Practice |
6204836794 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Christene Vancott CNM CFNP PC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | MD2006-0554 | NM | Yes |
Addresses
Primary practice location
2465 S Telshor Blvd
Las Cruces, NM 88011-5049
Mailing address
3100 Schofield Rd
BLDG 1179
Fort Sam Houston, TX 78234-7577
Phone (210) 808-2411
Other providers in Las Cruces, NM
- Aday Orthodontics, PC
- B Joe Aday
- James Bradley Aday
- Kwasi Addae-Mensah
- Addari Family Medicine LLC
- Hanan Addi
- Addus Healthcare, Inc.
- Jochebed Ade-Oshifogun
- Temitope Ade-Oshifogun
- Taiwo Babatunde Adedipe
All providers in Las Cruces, 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 Sep 16, 2016. 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.