Zia Internal Medicine Associates, LLC

Key facts

NPI: 1194239145
Entity type: Organization (NPI type 2)
Primary specialty: Internal Medicine Physician 207R00000X
Legal business name: ZIA INTERNAL MEDICINE ASSOCIATES, LLC
Practice address: 4001 Rodeo Rd
Santa Fe, NM 87507-4830
Phone: (505) 780-8381
Fax: (505) 467-8521
NPI assigned: Nov 29, 2017
Organization subpart: No

Authorized official

Name: Mehul Daulat, DO NPI 1508270745
Title: Owner
Phone: (602) 391-3968

Authorized official NPPES reports the authorized official by name only; the link goes to the one practitioner connected to this organization with that name.

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Mehul Daulat, D.O. Internal Medicine Physician · Santa Fe, NM · NPI 1508270745

Medicare reassignment NPD Authorized official INTERNAL MEDICINE · NM
Trisha Patel, MD Dermatology Physician · Santa Fe, NM · NPI 1053731927

Medicare reassignment NPD DERMATOLOGY · NM
Rebecca Lynn Bourbon, P.A.-C Physician Assistant · Rio Rancho, NM · NPI 1003973231

NPD (past)

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA number	Laboratory	Certificate	Expires
32D2161188	Zia Internal Medicine Associates LLC 4001 Rodeo Road, Santa Fe, NM 87507	Certificate of waiver	Jan 28, 2027

Medicare participation

Medicare fee-for-service enrollment: Enrolled in NM

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
O20180129000567	NM	Part B Supplier - Clinic/Group Practice	4981964616	Receives reassigned benefits from 2 practitioners Practice locations: Albuquerque, NM; Santa Fe, NM

National Provider Directory

Locations

881 Lead Ave SE
Ste A
Albuquerque, NM 87102
Phone (505) 780-8381

105 Mills Ave
Las Vegas, NM 87701
Phone (505) 425-3569

2213 Brothers Rd
Ste 700
Santa Fe, NM 87505
Phone (505) 780-8381

1650 Hospital Dr
Ste 800
Santa Fe, NM 87505
Phone (505) 395-3000

Interoperability endpoints

FHIR API: https://drchrono-fhirpresentation.everhealthsoftware.com/fhir/drchrono/504985/r4

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Dermatology Physician Group: 193200000X MULTI-SPECIALTY GROUP	207N00000X
Internal Medicine Physician Group: 193400000X SINGLE SPECIALTY GROUP	207R00000X			Yes

Addresses

Primary practice location

4001 Rodeo Rd
Santa Fe, NM 87507-4830

Mailing address

4001 Rodeo Rd
Santa Fe, NM 87507-4830
Phone (505) 780-8381

Other providers in Santa Fe, NM

All providers in Santa Fe, NM · Internal 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 May 16, 2023. 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.
Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.