NPIMap

Organization Active NPI

Pueblo of Isleta

Doing business as Isleta Health Center

  • Clinic/Center
  • Isleta, NM
National Provider Identifier
1194738328
Registry record updated Aug 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
PUEBLO OF ISLETA
Doing business as
Isleta Health Center
Pueblo of Isleta Health Center
Practice address
01 Sagebrush
Isleta, NM 87022
Phone
(505) 869-3200
Fax
(505) 869-4881
NPI assigned
Aug 15, 2006
Last updated
Aug 19, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2026

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

Authorized official

Name
Kimberly Pohl
Title
Ceo
Phone
(505) 869-3200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X NM Primary

Addresses

Primary practice location

01 Sagebrush
Isleta, NM 87022

Mailing address

PO Box 640
01 Sagebrush
Isleta, NM 87022

Other identifiers 1

IdentifierTypeStateIssuer
30852081MedicaidNM

Other names 2

  • Isleta Health Center Doing business as
  • Pueblo of Isleta Health Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040616000379 NM Part B Supplier - Clinic/Group Practice 9739080631 Receives reassigned benefits from 25 practitioners
1 other NPI on this enrollment
Practice locations: Albuquerque, NM

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Pueblo of Isleta Behavioral Health9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1 Sagebrush St SW
Albuquerque, NM 87105
Phone (505) 869-4463

Practitioners & affiliated clinicians

Practitioners 26

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 26

NPI Registry JSON

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

{
    "created_epoch": "1155600000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1787097600000",
    "number": "1194738328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 640",
            "address_2": "01 SAGEBRUSH",
            "city": "ISLETA",
            "state": "NM",
            "postal_code": "87022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "01 SAGEBRUSH",
            "city": "ISLETA",
            "state": "NM",
            "postal_code": "87022",
            "telephone_number": "505-869-3200",
            "fax_number": "505-869-4881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PUEBLO OF ISLETA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-15",
        "last_updated": "2026-08-19",
        "certification_date": "2026-08-19",
        "status": "A",
        "authorized_official_last_name": "POHL",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "505-869-3200"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NM",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30852081",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Isleta Health Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Pueblo of Isleta Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Isleta, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.