Individual provider Active NPI

Sharon Marie Mullis, DO

  • Family Medicine Physician
  • Los Lunas, NM
National Provider Identifier
1265627996
Registry record updated Nov 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A-1536-10 Issued in NM
Practice address
200 Emilio Lopez Rd NW
PMG Los Lunas
Los Lunas, NM 87031-6818
Phone
(505) 866-2700
Fax
(505) 866-2701
NPI assigned
Sep 6, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 3834 IA
Family Medicine Physician 207Q00000X A-1536-10 NM Primary

Addresses

Primary practice location

200 Emilio Lopez Rd NW
PMG Los Lunas
Los Lunas, NM 87031-6818

Mailing address

PO Box 26666
PHS Provider Enrollment
Albuquerque, NM 87125-6666
Phone (505) 923-6770

Other identifiers 1

IdentifierTypeStateIssuer
18503829MedicaidNM

Other names 1

  • Sharon Marie Mullis Former name

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
I20100420000404 NM Practitioner - Family Practice 2961582598 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Presbyterian Healthcare ServicesGroup PAC ID 9234041708, 1,390 clinicians

Practice addresses (Care Compare)

5901 Harper Dr NE
Albuquerque, NM 87109-3587
Phone (505) 823-8888

Hospital & facility affiliations

  • Ambercare Home Health Home health agency, Belen, NM, CCN 327123
  • Presbyterian Hospital Hospital, Albuquerque, NM, CCN 320021

Merit-based Incentive Payment System (MIPS)

Final score
88.68 of 100Reported as group
Quality
82.35
Promoting interoperability
100
Improvement activities
40
Cost
76.6

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A-1536-10NMMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Presbyterian Healthcare Services Family Medicine CurrentSince Mar 1, 2010 Accepting new patients
Presbyterian Healthcare Services CurrentSince Mar 1, 2010 Accepting new patients
Presbyterian Healthcare Services Past Accepting new patients

Locations

5901 Harper Dr NE
Albuquerque, NM 87109
Phone (505) 823-8233

4588 Paradise Blvd NW
Albuquerque, NM 87114
Phone (505) 923-2070

8300 Constitution Ave NE
Bldg D
Albuquerque, NM 87110
Phone (505) 291-2200

2200 W 21st St
Clovis, NM 88101
Phone (505) 769-7577

200 Emilio Lopez Rd NW
Los Lunas, NM 87031
Phone (505) 866-2700

Interoperability endpoints

  • Direct secure messaging: smullis24981@direct.phs.org

Organizations & group practices 3

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 3

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": "1189036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447027200000",
    "number": "1265627996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 26666",
            "address_2": "PHS PROVIDER ENROLLMENT",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871256666",
            "telephone_number": "505-923-6770",
            "fax_number": "505-923-5354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 EMILIO LOPEZ RD NW",
            "address_2": "PMG LOS LUNAS",
            "city": "LOS LUNAS",
            "state": "NM",
            "postal_code": "870316818",
            "telephone_number": "505-866-2700",
            "fax_number": "505-866-2701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULLIS",
        "first_name": "SHARON",
        "middle_name": "MARIE",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-06",
        "last_updated": "2015-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IA",
            "license": "3834",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NM",
            "license": "A-1536-10",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "18503829",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHARON",
            "last_name": "MULLIS",
            "middle_name": "MARIE",
            "credential": "DO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Los Lunas, NM

Sources for this page

Verify at the official NPI Registry.