Organization Active NPI

Masoud Khorsand-Sahbaie, MD PA

Doing business as Kymera Independent Physicians

  • Hematology & Oncology Physician
  • Carlsbad, NM
National Provider Identifier
1518277417
Registry record updated Apr 24, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
96299 Issued in NM
Legal business name
MASOUD KHORSAND-SAHBAIE, MD PA
Doing business as
Kymera Independent Physicians
Practice address
101 S Canal St
Carlsbad, NM 88220-5713
Phone
(575) 234-1471
Fax
(575) 234-1473
NPI assigned
Oct 14, 2010
Last updated
Apr 24, 2013By the provider in NPPES
Organization subpart
Yes
Parent organization
MASOUD KHORSAND-SAHBAIE, MD PAAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 24, 2013

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

Authorized official

Name
Brenda Cottrell
Title
Business Systems/Credentialing MGR
Phone
(575) 627-9508

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD2012-0215 NM
Hematology & Oncology Physician 207RH0003X MD2012-0091 NM
Hematology & Oncology Physician 207RH0003X MD2011-0742 NM
Hematology & Oncology Physician 207RH0003X 96299 NM Primary
Rheumatology Physician 207RR0500X MD2012-0244 NM

Addresses

Primary practice location

101 S Canal St
Carlsbad, NM 88220-5713

Mailing address

PO Box 1574
Roswell, NM 88202-1574
Phone (575) 627-9508

Other identifiers 1

IdentifierTypeStateIssuer
Z2565MedicaidNM

Other names 1

  • Kymera Independent Physicians Doing business as

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
32D2058294Masoud Khorsand - Sahbaie MD PA Dba Kymera101 South Canal, Carlsbad, NM 88220Certificate of waiverMay 2, 2027

National Provider Directory

National Provider Directory
Part of
Masoud Khorsand Sahbaie

Locations

402 W Country Club Rd
Roswell, NM 88201
Phone (575) 627-9500

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1287014400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1366761600000",
    "number": "1518277417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1574",
            "city": "ROSWELL",
            "state": "NM",
            "postal_code": "882021574",
            "telephone_number": "575-627-9508",
            "fax_number": "877-749-7764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 S CANAL ST",
            "city": "CARLSBAD",
            "state": "NM",
            "postal_code": "882205713",
            "telephone_number": "575-234-1471",
            "fax_number": "575-234-1473"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MASOUD KHORSAND-SAHBAIE, MD PA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MASOUD KHORSAND-SAHBAIE, MD PA",
        "enumeration_date": "2010-10-14",
        "last_updated": "2013-04-24",
        "status": "A",
        "authorized_official_last_name": "COTTRELL",
        "authorized_official_first_name": "BRENDA",
        "authorized_official_title_or_position": "BUSINESS SYSTEMS/CREDENTIALING MGR",
        "authorized_official_telephone_number": "575-627-9508"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NM",
            "license": "MD2012-0215",
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "NM",
            "license": "MD2012-0091",
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "NM",
            "license": "MD2011-0742",
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "NM",
            "license": "96299",
            "primary": true
        },
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "NM",
            "license": "MD2012-0244",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Z2565",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kymera Independent Physicians",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Carlsbad, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.