Individual provider Active NPI

Michelle Gallegos, C-PNP

  • Pediatric Nurse Practitioner
  • Albuquerque, NM
National Provider Identifier
1538742945
Registry record updated Jun 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
70791 Issued in NM
Practice address
8650 Alameda Blvd NE Ste 101
Albuquerque, NM 87122-3791
Phone
(505) 255-1866
NPI assigned
May 3, 2021
Last updated
Jun 23, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 70791 NM Primary
Registered Nurse 163W00000X 79165 NM

Addresses

Primary practice location

8650 Alameda Blvd NE Ste 101
Albuquerque, NM 87122-3791

Mailing address

336 Luis Sanchez PL SW
Albuquerque, NM 87105-6359
Phone (505) 927-2609

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Certified Pediatric Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
79165NMMDRegistered Nurse
70791NMMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
High Desert Pedicatrics PC PastSince Jun 25, 2023 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1620000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687478400000",
    "number": "1538742945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "336 LUIS SANCHEZ PL SW",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871056359",
            "telephone_number": "505-927-2609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8650 ALAMEDA BLVD NE STE 101",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871223791",
            "telephone_number": "505-255-1866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALLEGOS",
        "first_name": "MICHELLE",
        "name_prefix": "Ms.",
        "credential": "C-PNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-03",
        "last_updated": "2023-06-23",
        "certification_date": "2023-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NM",
            "license": "70791",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NM",
            "license": "79165",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2023; 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.