Individual provider Active NPI

Andrew Faturos

  • Student in an Organized Health Care Education/Training Program
  • Albuquerque, NM
National Provider Identifier
1245980648
Registry record updated Jun 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
License
RS2025-0191 Issued in NM
Practice address
Msc10 5550
1 University of New Mexico, Msc08 4700
Albuquerque, NM 87131-0001
Phone
(505) 272-4661
Fax
(505) 272-0475
NPI assigned
Mar 28, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 16, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Student in an Organized Health Care Education/Training Program 390200000X RS2025-0191 NM Primary

Addresses

Primary practice location

Msc10 5550
1 University of New Mexico, Msc08 4700
Albuquerque, NM 87131-0001

Mailing address

4150 V St # 1100
Sacramento, CA 95817-1460
Phone (916) 734-2737

Other practice location 1

4150 V St # 1100
Sacramento, CA 95817-1460
Phone (916) 734-2737

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, NM2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20230626002465 CA Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 1456719277
I20250620002750 NM Order and Referring Only - Cardiovascular Disease (Cardiology)Practitioner - Cardiovascular Disease (Cardiology) 1456719277

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1648425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750032000000",
    "number": "1245980648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4150 V ST # 1100",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958171460",
            "telephone_number": "916-734-2737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MSC10 5550",
            "address_2": "1 UNIVERSITY OF NEW MEXICO, MSC08 4700",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871310001",
            "telephone_number": "505-272-4661",
            "fax_number": "505-272-0475"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4150 V St # 1100",
            "address_purpose": "LOCATION",
            "city": "Sacramento",
            "state": "CA",
            "postal_code": "958171460",
            "country_code": "US",
            "telephone_number": "916-734-2737",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FATUROS",
        "first_name": "ANDREW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-03-28",
        "last_updated": "2025-06-16",
        "certification_date": "2025-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NM",
            "license": "RS2025-0191",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.