Individual provider Active NPI

Patricia Carabajal, MD

  • Family Medicine Physician
  • Albuquerque, NM
National Provider Identifier
1255366274
Registry record updated Oct 11, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
89-15 Issued in NM
Practice address
2121 Juan Tabo NE
Albuquerque, NM 87112
Phone
(505) 237-8800
Fax
(505) 237-8803
NPI assigned
Jul 11, 2006
Sex
Female
Sole proprietor
No

Organizations & group practices 2

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 2

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

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of New Mexico School of Medicine, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Optumcare New Mexico LLC 69 clinicians

Practice addresses (Care Compare)

2121 Juan Tabo Blvd NE
Albuquerque, NM 87112-3307
Phone (505) 237-8800

Hospital & facility affiliations

  • Ambercare Home Health Home health agency, Belen, NM, CCN 327123
  • Lovelace Women'S Hospital Hospital, Albuquerque, NM, CCN 320017

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060320000169 NM Practitioner - Family Practice 8820005648 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
89-15NMMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Optumcare New Mexico LLC Family Medicine CurrentSince Jun 1, 2006 Accepting new patients
Optumcare Endoscopy Center New Mexico, LLC Past Accepting new patients

Locations

2121 Juan Tabo Blvd NE
Albuquerque, NM 87112
Phone (505) 237-8800

5150 Journal Center Blvd NE
Fl 3
Albuquerque, NM 87109
Phone (505) 262-3212

601 Martin Luther King Ave NE
Albuquerque, NM 87102
Phone (505) 727-8040

5400 Gibson Blvd SE
Albuquerque, NM 87108
Phone (505) 262-7174

Interoperability endpoints

  • Direct secure messaging: pcarabajal119438@westdirect.optum.com

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 89-15 NM Primary

Addresses

NPPES NPI Registry

Primary practice location

2121 Juan Tabo NE
Albuquerque, NM 87112

Mailing address

PO Box 27829
Albuquerque, NM 87125
Phone (505) 232-1920

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
21246MedicaidNM

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Oct 11, 2011.

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318291200000",
    "number": "1255366274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 27829",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "87125",
            "telephone_number": "505-232-1920",
            "fax_number": "505-727-9276"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2121 JUAN TABO NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "87112",
            "telephone_number": "505-237-8800",
            "fax_number": "505-237-8803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARABAJAL",
        "first_name": "PATRICIA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-11",
        "last_updated": "2011-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NM",
            "license": "89-15",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "21246",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.