Organization Active NPI

Mariposa Family Medicine

  • Family Nurse Practitioner
  • Albuquerque, NM
National Provider Identifier
1396210506
Registry record updated Jul 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
MARIPOSA FAMILY MEDICINE
Practice address
5910 Cubero Dr NE Ste a
Albuquerque, NM 87109-3868
Phone
(505) 856-3321
Fax
(505) 212-0152
NPI assigned
Oct 4, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2024

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

Authorized official

Name
Tani Schare, FNP-CNPI 1831579531
Title
Owner
Phone
(505) 859-4191

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
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X Primary

Addresses

Primary practice location

5910 Cubero Dr NE Ste a
Albuquerque, NM 87109-3868

Mailing address

5910 Cubero Dr NE Ste a
Albuquerque, NM 87109-3868
Phone (505) 859-4191

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20181130002508 NM Part B Supplier - Clinic/Group Practice 5597009555 Receives reassigned benefits from 3 practitioners
Practice locations: Albuquerque, NM

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
32D2157153Mariposa Family Medicine5910 Cubero NE Ste a, Albuquerque, NM 87109Certificate of waiverOct 30, 2026

National Provider Directory

National Provider Directory

Locations

5910 Cubero Dr NE
Ste A
Albuquerque, NM 87109
Phone (505) 856-3321

Practitioners & affiliated clinicians

Practitioners 3

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": "1538611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1720483200000",
    "number": "1396210506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5910 CUBERO DR NE STE A",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871093868",
            "telephone_number": "505-859-4191",
            "fax_number": "505-308-3192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5910 CUBERO DR NE STE A",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871093868",
            "telephone_number": "505-856-3321",
            "fax_number": "505-212-0152"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARIPOSA FAMILY MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-04",
        "last_updated": "2024-07-09",
        "certification_date": "2024-07-09",
        "status": "A",
        "authorized_official_last_name": "SCHARE",
        "authorized_official_first_name": "TANI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "505-859-4191",
        "authorized_official_credential": "FNP-C"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.