Individual provider Active NPI

Martha Elia Reyes, FNP-C

  • Family Nurse Practitioner
  • Grants, NM
National Provider Identifier
1477043594
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
60147 Issued in NM
Practice address
1423 E Roosevelt Ave
Grants, NM 87020-2245
Phone
(505) 287-6500
NPI assigned
May 14, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X 60147 NM Primary

Addresses

Primary practice location

1423 E Roosevelt Ave
Grants, NM 87020-2245

Mailing address

20 Preserve Dr
Newnan, GA 30263-2283

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL Cibolafamilyhealthcenter CIBOLA SPECIALTY ASSOCIATES

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
I20200714000929 NM Practitioner - Nurse Practitioner 2769805415 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southwest Medical Associates, LLCGroup PAC ID 7214831114, 326 clinicians
Presbyterian Healthcare ServicesGroup PAC ID 9234041708, 1,390 clinicians

Practice addresses (Care Compare)

3900 Las Estancias CT SW
Albuquerque, NM 87121-5513
Phone (505) 727-4200

5901 Harper Dr NE
Albuquerque, NM 87109-3587
Phone (505) 823-8888

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
60147NMMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Southwest Medical Associates, LLC Single Specialty CurrentSince Oct 1, 2024 Accepting new patients
Cibola General Hospital Corporation Single Specialty CurrentSince Jun 25, 2020 Accepting new patients
Southwest Medical Associates, LLC CurrentSince Oct 1, 2024 Accepting new patients
Lovelace Urgent Care, LLC Single Specialty Past Accepting new patients

Locations

715 Martin Luther King Ave NE
Ste 301
Albuquerque, NM 87102
Phone (505) 727-4500

6701 Jefferson St NE
Albuquerque, NM 87109
Phone (505) 727-0600

4101 Indian School Rd NE
Ste 110
Albuquerque, NM 87110
Phone (505) 727-8360

1423 E Roosevelt Ave
Grants, NM 87020
Phone (505) 287-6500

Interoperability endpoints

  • Direct secure messaging: mreyes1136812@ahs.direct-ci.com

Organizations & group practices 5

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1526256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1477043594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 PRESERVE DR",
            "city": "NEWNAN",
            "state": "GA",
            "postal_code": "302632283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1423 E ROOSEVELT AVE",
            "city": "GRANTS",
            "state": "NM",
            "postal_code": "870202245",
            "telephone_number": "505-287-6500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYES",
        "first_name": "MARTHA",
        "middle_name": "ELIA",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-05-14",
        "last_updated": "2023-11-27",
        "certification_date": "2020-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "NM",
            "license": "60147",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Cibolafamilyhealthcenter",
            "affiliation": "Y",
            "affiliationName": "CIBOLA SPECIALTY ASSOCIATES",
            "address_1": "1423 E Roosevelt Ave",
            "city": "Grants",
            "state": "NM",
            "country_code": "US",
            "postal_code": "870202245",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Grants, NM

Sources for this page

Verify at the official NPI Registry.