NPIMap

Organization Active NPI

La Familia Primary Care P C

  • Clinic/Center
  • Raton, NM
National Provider Identifier
1366525537
Registry record updated Nov 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
96-165 Issued in NM
Legal business name
LA FAMILIA PRIMARY CARE P C
Practice address
190 Hospital Dr
Raton, NM 87740-2002
Phone
(575) 445-5563
Fax
(575) 445-5566
NPI assigned
Oct 23, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 23, 2022

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

Authorized official

Name
Misbah D Zmily, M.D.NPI 1285735332
Title
Ownerpresident
Phone
(505) 445-5563

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X 96-165 NM Primary

Addresses

Primary practice location

190 Hospital Dr
Raton, NM 87740-2002

Mailing address

190 Hospital Dr
Raton, NM 87740-2002
Phone (575) 445-5563

Other identifiers 2

IdentifierTypeStateIssuer
56903MedicaidNM
607623110POtherNMR.R. MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070226000048 NM Part B Supplier - Clinic/Group Practice 0446352207 Receives reassigned benefits from 4 practitioners
Practice locations: Raton, NM

National Provider Directory

National Provider Directory

Locations

190 Hospital Dr
Raton, NM 87740
Phone (505) 445-5563

130 S 3rd St
Raton, NM 87740
Phone (575) 445-5548

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1669161600000",
    "number": "1366525537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "190 HOSPITAL DR",
            "city": "RATON",
            "state": "NM",
            "postal_code": "877402002",
            "telephone_number": "575-445-5563",
            "fax_number": "575-445-5566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "190 HOSPITAL DR",
            "city": "RATON",
            "state": "NM",
            "postal_code": "877402002",
            "telephone_number": "575-445-5563",
            "fax_number": "575-445-5566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LA FAMILIA PRIMARY CARE P C",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-23",
        "last_updated": "2022-11-23",
        "certification_date": "2022-11-23",
        "status": "A",
        "authorized_official_last_name": "ZMILY",
        "authorized_official_first_name": "MISBAH",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNERPRESIDENT",
        "authorized_official_telephone_number": "505-445-5563",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NM",
            "license": "96-165",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "56903",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "R.R. MEDICARE",
            "identifier": "607623110P",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Raton, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.