Michelle Renee Lucero, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

2000PA27 Issued in NM

Practice address

4550 Eubank Blvd NE Ste D205
Albuquerque, NM 87111-3479

Phone

(505) 234-6432

Fax

(505) 234-6432

NPI assigned

Mar 7, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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

• Mariposa Transformation Wellness Center, LLC

  • Physician Assistant
  • Albuquerque, NM
  • NPI 1962127878
  NPD Authorized official

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

{
    "created_epoch": "1299456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744329600000",
    "number": "1194023671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4550 EUBANK BLVD NE STE D205",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871113479",
            "telephone_number": "505-234-6432",
            "fax_number": "505-234-6432"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4550 EUBANK BLVD NE STE D205",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871113479",
            "telephone_number": "505-234-6432",
            "fax_number": "505-234-6432"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13500 S Pleasant Valley Rd",
            "address_purpose": "LOCATION",
            "city": "Kuna",
            "state": "ID",
            "postal_code": "836342709",
            "country_code": "US",
            "telephone_number": "208-331-2760 x20851",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LUCERO",
        "first_name": "MICHELLE",
        "middle_name": "RENEE",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-07",
        "last_updated": "2025-04-11",
        "certification_date": "2025-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ID",
            "license": "PA-2326",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NM",
            "license": "2000PA27",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mariah J Lucero, PHARMD
• Marisela Arellano Lucero, RPH
• Mary Ann Lucero, DDS
• Michael Lucero, LPCC
• Michael Lucero
• Miriam Lucero, PHARMD
• Natasha Victoria Lucero, LMSW
• Nicole Danielle Lucero, FNP-C
• Olga Zavialova Lucero, FNP
• Orlando Lucero, RRT, MPH

• Physician Assistant in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Physician Assistant in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 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.