Individual provider Active NPI

Mahli Michael, PA-C

  • Physician Assistant
  • Las Cruces, NM
National Provider Identifier
1194730663
Registry record updated Nov 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA2004-0055 Issued in NM
Practice address
1770 Tierra de Mesilla
Las Cruces, NM 88005-3101
Phone
(575) 526-9189
Fax
(575) 652-4064
NPI assigned
Jul 30, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 23, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X PA2004-0055 NM
Physician Assistant 363A00000X PA2004-0055 NM Primary

Addresses

Primary practice location

1770 Tierra de Mesilla
Las Cruces, NM 88005-3101

Mailing address

PO Box 516
Mesilla, NM 88046-0516
Phone (575) 526-9189

Other identifiers 1

IdentifierTypeStateIssuer
84576863MedicaidNM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051206001042 NM Practitioner - Physician Assistant 1355366592 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Arthritis Treatment Specialists LLCGroup PAC ID 4789831363, 2 clinicians

Practice addresses (Care Compare)

1770 Tierra de Mesilla
Las Cruces, NM 88005-3957
Phone (575) 526-9189

Hospital & facility affiliations

  • Memorial Medical Center Hospital, Las Cruces, NM, CCN 320018
  • Mountain View Regional Medical Center Hospital, Las Cruces, NM, CCN 320085
  • Gila Regional Medical Center Hospital, Silver City, NM, CCN 321311
  • Christus Southern New Mexico Hospital, Alamogordo, NM, CCN 320004
  • Three Crosses Regional Hospital LLC Hospital, Las Cruces, NM, CCN 320091

Merit-based Incentive Payment System (MIPS)

Final score
78.62 of 100Reported as group
Quality
80.21
Promoting interoperability
94
Improvement activities
40
Cost
53.52

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA2004-0055NMMDPhysician Assistant

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/JFCDCA/Endpoint/JFCDCA

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 and National Provider Directory roles.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1154217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637625600000",
    "number": "1194730663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 516",
            "city": "MESILLA",
            "state": "NM",
            "postal_code": "880460516",
            "telephone_number": "575-526-9189",
            "fax_number": "575-652-4064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1770 TIERRA DE MESILLA",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880053101",
            "telephone_number": "575-526-9189",
            "fax_number": "575-652-4064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICHAEL",
        "first_name": "MAHLI",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-30",
        "last_updated": "2021-11-23",
        "certification_date": "2021-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NM",
            "license": "PA2004-0055",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NM",
            "license": "PA2004-0055",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "84576863",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Cruces, NM

Sources for this page

Verify at the official NPI Registry.