NPIMap

Organization Active NPI

Mirage Wellness Center & Medspa Limited Liability Company

  • General Practice Physician
  • Rio Rancho, NM
National Provider Identifier
1427996347
Registry record updated Mar 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
MIRAGE WELLNESS CENTER & MEDSPA LIMITED LIABILITY COMPANY
Practice address
1400 Barbara Loop SE Ste a
Rio Rancho, NM 87124-1088
Phone
(505) 420-3737
Fax
(505) 420-3738
NPI assigned
Mar 23, 2026
Last updated
Mar 23, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2026

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

Authorized official

Name
Elena Martinez, PRACTICE MANAGER
Title
Practice Manager
Phone
(505) 420-3737

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X Primary

Addresses

Primary practice location

1400 Barbara Loop SE Ste a
Rio Rancho, NM 87124-1088

Mailing address

1400 Barbara Loop SE Ste a
Rio Rancho, NM 87124-1088
Phone (505) 420-3737

National Provider Directory

National Provider Directory

Locations

1400 Barbara Loop SE
Ste A
Rio Rancho, NM 87124
Phone (505) 414-6449

NPI Registry JSON

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

{
    "created_epoch": "1774224000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1774224000000",
    "number": "1427996347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 BARBARA LOOP SE STE A",
            "city": "RIO RANCHO",
            "state": "NM",
            "postal_code": "871241088",
            "telephone_number": "505-420-3737",
            "fax_number": "505-420-3738"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 BARBARA LOOP SE STE A",
            "city": "RIO RANCHO",
            "state": "NM",
            "postal_code": "871241088",
            "telephone_number": "505-420-3737",
            "fax_number": "505-420-3738"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIRAGE WELLNESS CENTER & MEDSPA LIMITED LIABILITY COMPANY",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-03-23",
        "last_updated": "2026-03-23",
        "certification_date": "2026-03-23",
        "status": "A",
        "authorized_official_last_name": "MARTINEZ",
        "authorized_official_first_name": "ELENA",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "505-420-3737",
        "authorized_official_credential": "PRACTICE MANAGER"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rio Rancho, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.