Individual provider Active NPI

Pete Joseph Sedillo III, PHARMD

  • Pharmacist
  • Albuquerque, NM
National Provider Identifier
1184108094
Registry record updated Apr 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
RP00008984 Issued in NM
Practice address
2100 Louisiana Blvd NE Ste 460
Albuquerque, NM 87110-5437
Phone
(505) 705-3540
NPI assigned
Sep 18, 2018
Last updated
Apr 30, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X RP00008984 NM Primary

Addresses

Primary practice location

2100 Louisiana Blvd NE Ste 460
Albuquerque, NM 87110-5437

Mailing address

6801 Avenida la Costa NE
Albuquerque, NM 87109-4021
Phone (505) 948-6584

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
RP00008984NMMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Southwest Home Solutions LLC CurrentSince Oct 27, 2019 Accepting new patients

Locations

205 Silver Ave SW
Ste D
Albuquerque, NM 87102
Phone (505) 705-3540

2100 Louisiana Blvd NE
Ste 460
Albuquerque, NM 87110
Phone (505) 705-3540

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": "1537228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745971200000",
    "number": "1184108094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6801 AVENIDA LA COSTA NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871094021",
            "telephone_number": "505-948-6584"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 LOUISIANA BLVD NE STE 460",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871105437",
            "telephone_number": "505-705-3540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEDILLO",
        "first_name": "PETE",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-09-18",
        "last_updated": "2025-04-30",
        "certification_date": "2025-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NM",
            "license": "RP00008984",
            "primary": true
        }
    ],
    "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 Apr 30, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.