Individual provider Active NPI

Ana Sutulov Marin, CPT

  • Phlebotomy Technician
  • Corrales, NM
National Provider Identifier
1609710318
Registry record updated Apr 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Phlebotomy TechnicianTaxonomy code 246RP1900X
License
N25106492 Issued in NM
Practice address
407 W la Entrada
Corrales, NM 87048-8694
Phone
(505) 264-5054
NPI assigned
Apr 15, 2026
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 15, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Phlebotomy Technician 246RP1900X F2Z2P5E8 NM
Phlebotomy Technician 246RP1900X N25106492 NM Primary

Addresses

Primary practice location

407 W la Entrada
Corrales, NM 87048-8694

Mailing address

407 W la Entrada
Corrales, NM 87048-8694
Phone (505) 264-5054

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

State licenses

LicenseStateTypeSpecialty
F2Z2P5E8NMMDPhlebotomy Technician
N25106492NMMDPhlebotomy Technician

NPI Registry JSON

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

{
    "created_epoch": "1776211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776211200000",
    "number": "1609710318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "407 W LA ENTRADA",
            "city": "CORRALES",
            "state": "NM",
            "postal_code": "870488694",
            "telephone_number": "505-264-5054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "407 W LA ENTRADA",
            "city": "CORRALES",
            "state": "NM",
            "postal_code": "870488694",
            "telephone_number": "505-264-5054"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUTULOV MARIN",
        "first_name": "ANA",
        "credential": "CPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-04-15",
        "last_updated": "2026-04-15",
        "certification_date": "2026-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246RP1900X",
            "taxonomy_group": "",
            "desc": "Technician, Pathology, Phlebotomy",
            "state": "NM",
            "license": "F2Z2P5E8",
            "primary": false
        },
        {
            "code": "246RP1900X",
            "taxonomy_group": "",
            "desc": "Technician, Pathology, Phlebotomy",
            "state": "NM",
            "license": "N25106492",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corrales, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2026; 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.