Individual provider Active NPI

Maricar Tacbad

  • Physician Assistant
  • Albuquerque, NM
National Provider Identifier
1225765480
Registry record updated Aug 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA2024-0074 Issued in NM
Practice address
5700 Harper Dr NE
Albuquerque, NM 87109-3573
Phone
(505) 843-7813
NPI assigned
Aug 6, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 20, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA2024-0074 NM Primary

Addresses

Primary practice location

5700 Harper Dr NE
Albuquerque, NM 87109-3573

Mailing address

5700 Harper Dr NE
Albuquerque, NM 87109-3573
Phone (505) 843-7813

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
I20240913000160 NM Practitioner - Physician Assistant 9335689611 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southwest Women'S Oncology IncGroup PAC ID 7012923147, 12 clinicians

Practice addresses (Care Compare)

2025 Galisteo St
Suite B
Santa Fe, NM 87505-2101
Phone (505) 843-7813

2400 Unser Blvd SE
Suite 28300
Albuquerque, NM 87124-3392
Phone (505) 843-7813

Hospital & facility affiliations

  • Presbyterian Hospital Hospital, Albuquerque, NM, CCN 320021
  • Christus St Vincent Regional Medical Center Hospital, Santa Fe, NM, CCN 320002
  • Lovelace Women'S Hospital Hospital, Albuquerque, NM, CCN 320017
  • Cibola General Hospital Hospital, Grants, NM, CCN 321308

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA2024-0074NMMDPhysician Assistant

Interoperability endpoints

  • Direct secure messaging: mtacbad875324@ahs.direct-ci.com

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": "1659744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724112000000",
    "number": "1225765480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5700 HARPER DR NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871093573",
            "telephone_number": "505-843-7813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5700 HARPER DR NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871093573",
            "telephone_number": "505-843-7813"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TACBAD",
        "first_name": "MARICAR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-08-06",
        "last_updated": "2024-08-20",
        "certification_date": "2024-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NM",
            "license": "PA2024-0074",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.