Myrna L Policarpio, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DD2984 Issued in NM

Practice address

1960 N Date St
T Or C, NM 87901-3701

Phone

(575) 894-7662

Fax

(575) 894-7930

NPI assigned

Apr 30, 2008

Last updated

Aug 24, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Ben Archer Health Center

  • Federally Qualified Health Center (FQHC)
  • Las Cruces, NM
  • NPI 1699105320
  NPD (past)
• Ben Archer Health Center

  • Federally Qualified Health Center (FQHC)
  • Radium Springs, NM
  • NPI 1770734865
  NPD (past)
• Ben Archer Health Center

  • Federally Qualified Health Center (FQHC)
  • Alamogordo, NM
  • NPI 1902831977
  NPD (past)

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

{
    "created_epoch": "1209513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598227200000",
    "number": "1386810331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 370",
            "city": "HATCH",
            "state": "NM",
            "postal_code": "879370370",
            "telephone_number": "575-267-3280",
            "fax_number": "575-267-1747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1960 N DATE ST",
            "city": "T OR C",
            "state": "NM",
            "postal_code": "879013701",
            "telephone_number": "575-894-7662",
            "fax_number": "575-894-7930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLICARPIO",
        "first_name": "MYRNA",
        "middle_name": "L",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-30",
        "last_updated": "2020-08-24",
        "certification_date": "2020-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NM",
            "license": "DD2984",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Richard R. Mireles
• Annette A Miyamoto, LPN
• Carol Morrell, PA-C
• Vishna Peoples, CPSW
• Matthew Myers Peters, CNP
• Ashleigh Pratt, LCSW, LICSW
• Carol Renninger, LISW
• Darlene Rouse
• Rustic Health LLC
• Mary Rebecca Rylance, PA

• General Practice Dentistry in T Or C, NM
• Providers in T Or C, NM by specialty
• General Practice Dentistry in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.