Cathleen Durell, M.D.
Individual provider Active NPI Family Medicine Physician · Bernalillo, NM
NPI 1356497879 · NPPES record last updated Aug 29, 2022
Key facts
- NPI
- 1356497879
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 95228 (NM)
- Practice address
- 203 Sandia Day School Road
Bernalillo, NM 87004-7076 - Phone
- (505) 867-4696
- Fax
- (505) 867-4997
- NPI assigned
- Jan 26, 2007
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 4
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040303000602 | TX | Practitioner - Family Practice | 2567359599 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 95228 | NM | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pueblo of Sandia | Current |
Accepting new patients | |
| Jicarilla IHS Pharmacy | Past |
Accepting new patients | |
| Santa Clara Health Center | Past |
Accepting new patients | |
| Santa Fe Indian Hospital | Past | Accepting new patients |
Locations
481 Sandia Loop
Sandia Pueblo, NM 87004
Phone (505) 867-4696
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 95228 | NM | Yes |
Addresses
Primary practice location
203 Sandia Day School Road
Bernalillo, NM 87004-7076
Mailing address
481 Sandia Loop
Bernalillo, NM 87004-7076
Phone (505) 867-4696
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| Q4512 | Medicaid | NM |
Other names
- Cathleen Ryan
Other providers in Bernalillo, NM
- Alexandra De Vere
- Tanya C Deets
- Gabriel Diaz
- Susan E Duncan
- Elisabeth Durbano
- Marie Antonette Eichwald
- El Pueblo Health Services, Inc
- El Pueblo Health Services, Inc
- El Pueblo Healthcare
- Blanca Elia
All providers in Bernalillo, NM · Family Medicine Physician in New Mexico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 29, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.