Individual provider Active NPI

Sandra Lynn Whisler, MD

  • Pediatrics Physician
  • Albuquerque, NM
National Provider Identifier
1316954365
Registry record updated Sep 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
92-157 Issued in NM
Practice address
2724 Vassar PL NE
Albuquerque, NM 87107-1869
NPI assigned
Aug 2, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 26, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 92-157 NM Primary

Addresses

Primary practice location

2724 Vassar PL NE
Albuquerque, NM 87107-1869

Mailing address

11216 Desert Classic LN NE
Albuquerque, NM 87111-6599
Phone (505) 440-4303

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
I20040525000033 NM Practitioner - Pediatric Medicine 4688655996 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
92-157NMMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Presbyterian Healthcare Services CurrentSince Mar 12, 2019 Accepting new patients
Presbyterian Healthcare Services Pediatrics CurrentSince Mar 12, 2019 Accepting new patients

Locations

201 Cedar St SE
Ste 4600
Albuquerque, NM 87106
Phone (505) 563-6450

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

Interoperability endpoints

  • Direct secure messaging: sandra.whisler.1@22389.direct.athenahealth.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1154476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727308800000",
    "number": "1316954365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11216 DESERT CLASSIC LN NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871116599",
            "telephone_number": "505-440-4303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2724 VASSAR PL NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871071869"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHISLER",
        "first_name": "SANDRA",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-02",
        "last_updated": "2024-09-26",
        "certification_date": "2024-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NM",
            "license": "92-157",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.