Individual provider Active NPI

Alexandra Lusk, MD

  • Obstetrics & Gynecology Physician
  • Albuquerque, NM
National Provider Identifier
1568826352
Registry record updated Oct 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
MD2022-0173 Issued in NM
Practice address
4705 Montgomery Blvd NE Ste 301
Albuquerque, NM 87109-1234
Phone
(505) 727-4500
Fax
(505) 727-9590
NPI assigned
Apr 7, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NM
Student in an Organized Health Care Education/Training Program 390200000X
Obstetrics & Gynecology Physician 207V00000X MD2022-0173 NM Primary

Addresses

Primary practice location

4705 Montgomery Blvd NE Ste 301
Albuquerque, NM 87109-1234

Mailing address

4705 Montgomery Blvd NE Ste 301
Albuquerque, NM 87109-1234
Phone (505) 727-4500

Other practice location 1

1 University Of New Mexico
Albuquerque, NM 87131-6056
Phone (505) 272-4051

Other identifiers 1

IdentifierTypeStateIssuer
16823303MedicaidNM

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221102001685 NM Practitioner - Obstetrics/Gynecology 2668738030 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Southwest Medical Associates, LLC CurrentSince Nov 1, 2022 Accepting new patients
Southwest Medical Associates, LLC CurrentSince Nov 1, 2022 Accepting new patients
St Vincent Hospital Past Accepting new patients
Taos Health Systems, Inc., Holy Cross Hospital Past Accepting new patients
Lovelace Health System, LLC Past Accepting new patients

Locations

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

10511 Golf Course Rd NW
Ste 201
Albuquerque, NM 87114
Phone (505) 232-1180

4705 Montgomery Blvd NE
Ste 301
Albuquerque, NM 87109
Phone (505) 727-4500

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

Interoperability endpoints

  • Direct secure messaging: alusk172965@ahs.direct-ci.com

Organizations & group practices 6

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": "1459987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666051200000",
    "number": "1568826352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4705 MONTGOMERY BLVD NE STE 301",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871091234",
            "telephone_number": "505-727-4500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4705 MONTGOMERY BLVD NE STE 301",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871091234",
            "telephone_number": "505-727-4500",
            "fax_number": "505-727-9590"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 University Of New Mexico",
            "address_purpose": "LOCATION",
            "city": "Albuquerque",
            "state": "NM",
            "postal_code": "871316056",
            "country_code": "US",
            "telephone_number": "505-272-4051",
            "fax_number": "505-272-6385",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LUSK",
        "first_name": "ALEXANDRA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-07",
        "last_updated": "2022-10-18",
        "certification_date": "2022-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NM",
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NM",
            "license": "MD2022-0173",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "16823303",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.