Organization Active NPI

Mobile Dermatology Partners LLC

  • Dermatology Physician
  • Albuquerque, NM
National Provider Identifier
1295665446
Registry record updated May 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
MOBILE DERMATOLOGY PARTNERS LLC
Practice address
3636 Menaul Blvd NE Ste 108
Albuquerque, NM 87110-2842
Phone
(505) 816-0159
Fax
(480) 240-5931
NPI assigned
May 20, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 20, 2026

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

Authorized official

Name
Jonathan Harris, PA-C
Title
Owner
Phone
(480) 461-9822

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207N00000X Primary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X

Addresses

Primary practice location

3636 Menaul Blvd NE Ste 108
Albuquerque, NM 87110-2842

Mailing address

3636 Menaul Blvd NE Ste 108
Albuquerque, NM 87110-2842
Phone (505) 816-0159

National Provider Directory

National Provider Directory

Locations

3636 Menaul Blvd NE
Ste 108
Albuquerque, NM 87110
Phone (505) 816-0159

NPI Registry JSON

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

{
    "created_epoch": "1779235200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1779235200000",
    "number": "1295665446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3636 MENAUL BLVD NE STE 108",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871102842",
            "telephone_number": "505-816-0159",
            "fax_number": "480-240-5931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3636 MENAUL BLVD NE STE 108",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871102842",
            "telephone_number": "505-816-0159",
            "fax_number": "480-240-5931"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOBILE DERMATOLOGY PARTNERS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-05-20",
        "last_updated": "2026-05-20",
        "certification_date": "2026-05-20",
        "status": "A",
        "authorized_official_last_name": "HARRIS",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "480-461-9822",
        "authorized_official_credential": "PA-C"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.