Individual provider Active NPI

Stephanie Alcaraz-Reza, PA

  • Medical Physician Assistant
  • Albuquerque, NM
National Provider Identifier
1609225184
Registry record updated Jun 6, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
Practice address
9388 Valley View Dr NW
Albuquerque, NM 87114-4908
Phone
(505) 503-8806
NPI assigned
Jun 6, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X Primary

Addresses

Primary practice location

9388 Valley View Dr NW
Albuquerque, NM 87114-4908

Mailing address

130 Koontz Rd
Corrales, NM 87048-9002
Phone (314) 517-5824

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
I20160829001422 NM Practitioner - Physician Assistant 5890080964 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
McLeod Medical Centers of NM IncGroup PAC ID 5092075531, 54 clinicians

Practice addresses (Care Compare)

1108 US Route 66 W
Moriarty, NM 87035-1006
Phone (505) 281-5180

1901 Juan Tabo Blvd NE
Albuquerque, NM 87112-3303
Phone (505) 281-5180

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
McLeod Medical Centers of NM, Inc. CurrentSince Feb 13, 2025 Accepting new patients

Locations

4410 Irving Blvd NW
Albuquerque, NM 87114
Phone (505) 768-6123

11501 Montgomery Blvd NE
Albuquerque, NM 87111
Phone (505) 814-1333

3121 Carlisle Blvd NE
Albuquerque, NM 87110
Phone (505) 228-2108

7200 Montgomery Blvd NE
Albuquerque, NM 87109
Phone (505) 814-1995

1901 Juan Tabo Blvd NE
Albuquerque, NM 87112
Phone (505) 262-9200

12127 N State Highway 14
Ste 5
Cedar Crest, NM 87008
Phone (505) 281-2460

1851 Old US 66
Edgewood, NM 87015
Phone (505) 281-8463

517 E Nizhoni Blvd
Gallup, NM 87301
Phone (505) 326-2255

1202 Main St NE
Ste A
Los Lunas, NM 87031
Phone (505) 565-0070

Interoperability endpoints

  • Direct secure messaging: stephanie.alcaraz-reza.1@27050.direct.athenahealth.com

Organizations & group practices 2

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": "1465171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465171200000",
    "number": "1609225184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 KOONTZ RD",
            "city": "CORRALES",
            "state": "NM",
            "postal_code": "870489002",
            "telephone_number": "314-517-5824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9388 VALLEY VIEW DR NW",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871144908",
            "telephone_number": "505-503-8806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALCARAZ-REZA",
        "first_name": "STEPHANIE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-06",
        "last_updated": "2016-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.