Pueblo of Isleta
Organization Active NPI Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy · Isleta, NM
NPI 1407979008 · NPPES record last updated Aug 19, 2026
Key facts
- NPI
- 1407979008
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy 332800000X
- License
- 501C (NM)
- Legal business name
- PUEBLO OF ISLETA
- Practice address
- 01 Sagebrush St
Isleta, NM 87022-0000 - Phone
- (505) 869-4863
- Fax
- (505) 869-4811
- NPI assigned
- Apr 9, 2007
- Organization subpart
- No
Authorized official
- Name
- Kimberly Pohl
- Title
- Ceo
- Phone
- (505) 869-3200
Other NPIs with the same Medicare PAC ID 2
Corporate family (same tax ID) 8
Practitioners 33
-
Lisa K Cherino, LMSW,LADAC
-
Ryan Holiday, OD
-
Ray Kelley, MD
-
Anna Kistin, MD
-
Riley Nelson, MD
-
Hadley Rose Pope, MD
-
Karen Marie Roop, R.D, L.D
-
Theresa Ortiz, LMSW
-
Joel A. Di Santi, DPM
-
Paige Elizabeth Gaut, DPT
-
Mark William Hedrick, AUD, CCC-A
-
Jessica Chynoweth, M.D
-
Elizabeth Cumby, MD
-
Leslie J Herman, PT
-
Martin Jon Kileen, M.D.,M.P.H.
-
Daniel Langsam, MD
-
Gabriel I Rael, LMHC
-
Emily Rothman, DO
-
Sean A Salazar, PT
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NM
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20170126001345 | NM | Part B Supplier - Pharmacy | 9739080631 | Practice locations: Albuquerque, NM |
National Provider Directory
- Tax ID family
- Pueblo of Isleta Behavioral Health
Locations
1 Sagebrush St SW
Albuquerque, NM 87105
Phone (505) 869-4463
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | 332800000X | 501C | NM | Yes |
Addresses
Primary practice location
01 Sagebrush St
Isleta, NM 87022-0000
Mailing address
01 Sagebrush St
Isleta, NM 87022-0000
Phone (505) 869-4863
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00010146 | Medicaid | NM |
Other names
- Pueblo of Isleta Pharmacy
Other providers in Isleta, NM
- Pueblo of Isleta
- Pueblo of Isleta
- Pueblo of Isleta
- Pueblo of Isleta
- Pueblo of Isleta
- Pueblo of Isleta Assisted Living Facility
- Pueblo of Isleta Behavioral Health
- Gabriel I Rael
- John James Richter III
- Karen Marie Roop
All providers in Isleta, NM · Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy 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 19, 2026. 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.