Individual provider Active NPI

Sheila R Misra, CNP

  • Adult Health Nurse Practitioner
  • Albuquerque, NM
National Provider Identifier
1366766172
Registry record updated Dec 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
CNP-01527 Issued in NM
Practice address
1217 1St St NW
Albuquerque, NM 87102-1529
Phone
(505) 766-5197
Fax
(505) 287-5393
NPI assigned
Mar 23, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X CNP-01527 NM Primary

Addresses

Primary practice location

1217 1St St NW
Albuquerque, NM 87102-1529

Mailing address

PO Box 25445
Albuquerque, NM 87125-0445
Phone (505) 766-5197

Other identifiers 1

IdentifierTypeStateIssuer
03407071MedicaidNM

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100826001063 NM Practitioner - Nurse Practitioner 3779607734 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
CNP-01527NMMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Misra Medical LLC Adult Health Current Accepting new patients
Albuquerque Health Care for the Homeless, Inc. CurrentSince Dec 18, 2023 Accepting new patients

Locations

1217 1st St NW
Albuquerque, NM 87102
Phone (505) 242-4644

8232 Louisiana Blvd NE
Ste A
Albuquerque, NM 87113
Phone (505) 243-7670

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/IJDGBD

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1269302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703808000000",
    "number": "1366766172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 25445",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871250445",
            "telephone_number": "505-766-5197"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1217 1ST ST NW",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871021529",
            "telephone_number": "505-766-5197",
            "fax_number": "505-287-5393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MISRA",
        "first_name": "SHEILA",
        "middle_name": "R",
        "name_prefix": "Ms.",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-03-23",
        "last_updated": "2023-12-29",
        "certification_date": "2023-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NM",
            "license": "CNP-01527",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03407071",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.