Individual provider Active NPI

John P Mahony, PA

  • Physician Assistant
  • Taos, NM
National Provider Identifier
1497084396
Registry record updated Jul 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA2019-0019 Issued in NM
Practice address
330 Paseo del Pueblo Sur Ste C
Taos, NM 87571-5328
Phone
(575) 758-1414
Fax
(575) 758-1474
NPI assigned
Dec 24, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 085001767 IL
Physician Assistant 363A00000X PA2019-0019 NM Primary

Addresses

Primary practice location

330 Paseo del Pueblo Sur Ste C
Taos, NM 87571-5328

Mailing address

330 Paseo del Pueblo Sur Ste C
Taos, NM 87571-5328
Phone (575) 758-1414

Other practice location 1

1800 Unser Blvd NW Ste 500
Albuquerque, NM 87120-4353
Phone (505) 205-1271

Other practice location 2

5504 Menaul Blvd NE Ste F
Albuquerque, NM 87110-3184
Phone (505) 348-2868

Other practice location 3

8201 Golf Course Rd NW Ste A3
Albuquerque, NM 87120-5803
Phone (505) 800-7070

Other practice location 4

1630 Rio Rancho Blvd SE Ste 101
Rio Rancho, NM 87124-1587
Phone (505) 395-5520

Other practice location 5

9551 Paseo Del Norte NE Ste D-106
Albuquerque, NM 87122-2975
Phone (505) 800-7050

Other identifiers 1

IdentifierTypeStateIssuer
17576741MedicaidNM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM, TX2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20191118000726 NM Practitioner - Physician Assistant 6406989730 Reassigns benefits to 3 organizations
I20200501001951 TX Practitioner - Physician Assistant 6406989730 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Lovelace Urgent Care LLCGroup PAC ID 3375067663, 18 clinicians

Practice addresses (Care Compare)

330 Paseo del Pueblo Sur
Suite C
Taos, NM 87571-5328
Phone (575) 758-1414

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA2019-0019NMMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Cherokee Nation Current Accepting new patients
Cherokee Nation CurrentSince Apr 26, 2020 Accepting new patients
Rehoboth McKinley Christian Health Care Services, Inc Current Accepting new patients
Cherokee Nation CurrentSince Apr 26, 2020 Accepting new patients
Cherokee Nation Current Accepting new patients
Rehoboth McKinley Christian Health Care Services, Inc CurrentSince Oct 1, 2019 Accepting new patients
Taos Health Systems, Inc., Holy Cross Hospital Past Accepting new patients

Locations

1901 Red Rock Dr
Gallup, NM 87301
Phone (505) 863-7000

1900 Red Rock Dr
Gallup, NM 87301
Phone (505) 863-1820

2111 College Dr
Gallup, NM 87301
Phone (505) 397-5172

859 E Melton Dr
Jay, OK 74346
Phone (918) 253-4271

1001 S 41st St E
#3
Muskogee, OK 74403
Phone (918) 687-0201

1020 Lenape Dr
Nowata, OK 74048
Phone (918) 273-0192

900 N Owen Walters Blvd
Salina, OK 74365
Phone (918) 434-8500

100 S Bliss Ave
Tahlequah, OK 74464
Phone (918) 458-3100

Dept 2269
Tulsa, OK 74182

27371 S 4410 Rd
Vinita, OK 74301
Phone (918) 256-4800

Interoperability endpoints

  • Direct secure messaging: jmahony1339377@ahs.direct-ci.com

Organizations & group practices 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1261612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753833600000",
    "number": "1497084396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 PASEO DEL PUEBLO SUR STE C",
            "city": "TAOS",
            "state": "NM",
            "postal_code": "875715328",
            "telephone_number": "575-758-1414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 PASEO DEL PUEBLO SUR STE C",
            "city": "TAOS",
            "state": "NM",
            "postal_code": "875715328",
            "telephone_number": "575-758-1414",
            "fax_number": "575-758-1474"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1800 Unser Blvd NW Ste 500",
            "address_purpose": "LOCATION",
            "city": "Albuquerque",
            "state": "NM",
            "postal_code": "871204353",
            "country_code": "US",
            "telephone_number": "505-205-1271",
            "fax_number": "505-205-1085",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5504 Menaul Blvd NE Ste F",
            "address_purpose": "LOCATION",
            "city": "Albuquerque",
            "state": "NM",
            "postal_code": "871103184",
            "country_code": "US",
            "telephone_number": "505-348-2868",
            "fax_number": "505-348-2867",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8201 Golf Course Rd NW Ste A3",
            "address_purpose": "LOCATION",
            "city": "Albuquerque",
            "state": "NM",
            "postal_code": "871205803",
            "country_code": "US",
            "telephone_number": "505-800-7070",
            "fax_number": "505-800-7075",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1630 Rio Rancho Blvd SE Ste 101",
            "address_purpose": "LOCATION",
            "city": "Rio Rancho",
            "state": "NM",
            "postal_code": "871241587",
            "country_code": "US",
            "telephone_number": "505-395-5520",
            "fax_number": "505-395-5517",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9551 Paseo Del Norte NE Ste D-106",
            "address_purpose": "LOCATION",
            "city": "Albuquerque",
            "state": "NM",
            "postal_code": "871222975",
            "country_code": "US",
            "telephone_number": "505-800-7050",
            "fax_number": "505-800-7051",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAHONY",
        "first_name": "JOHN",
        "middle_name": "P",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-12-24",
        "last_updated": "2025-07-30",
        "certification_date": "2025-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085001767",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NM",
            "license": "PA2019-0019",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "17576741",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Taos, NM

Sources for this page

Verify at the official NPI Registry.