Active NPI
Christian Tyler Smith, D.O.
- Family Medicine Physician
- Albuquerque, NM
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- DO2024-0037
- Practice address
- 601 Dr Martin Luther King Jr Ave NE
Albuquerque, NM 87102-3619 - Phone
- (505) 727-8360
- NPI assigned
- Apr 15, 2021
- Last updated
- Jul 3, 2024
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | NM | ||
| Family Medicine Physician | 207Q00000X | DO2024-0037 | NM | Primary |
Addresses
Primary practice location
601 Dr Martin Luther King Jr Ave NE
Albuquerque, NM 87102-3619
Mailing address
601 Dr Martin Luther King Jr Ave NE
Albuquerque, NM 87102-3619
Phone (505) 727-8360
Other practice location 1
Msc 09 5040 1 University Of New Mexico
Albuquerque, NM 87131-0001
Phone (505) 272-6607
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| DO2024-0037 | Other | NM | NM LICENSE |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Other, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
601 Dr Martin Luther King Jr Ave NE
Albuquerque, NM 87102-3619
Phone (505) 727-8000
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DO2024-0037 | NM | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southwest Medical Associates, LLC | Family Medicine | Current | Accepting new patients |
| Southwest Medical Associates, LLC | Family Medicine | Current | Accepting new patients |
| Lovelace Health System LLC | Past | Accepting new patients |
Locations
4101 Indian School Rd NE
Ste 110
Albuquerque, NM 87110
Phone (505) 727-8360
4701 Montgomery Blvd NE
Albuquerque, NM 87109
Phone (505) 727-2000
601 Martin Luther King Ave NE
Albuquerque, NM 87102
Phone (505) 727-8040
715 Martin Luther King Ave NE
Ste 301
Albuquerque, NM 87102
Phone (505) 727-4500
Interoperability endpoints
- csmith276770@ahs.direct-ci.com
Organizations & group practices 3
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.
-
dba Lovelace Medical Group
- General Practice Physician
- Albuquerque, NM
- NPI 1164491072
Family Medicine
-
- Rural Health Clinic/Center
- Roswell, NM
- NPI 1578255253
Family Medicine
-
- General Acute Care Hospital
- Albuquerque, NM
- NPI 1306914213
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Albuquerque, NM
- NPI 1306914213
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1618444800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1719964800000",
"number": "1639750342",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "601 DR MARTIN LUTHER KING JR AVE NE",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871023619",
"telephone_number": "505-727-8360"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "601 DR MARTIN LUTHER KING JR AVE NE",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871023619",
"telephone_number": "505-727-8360"
}
],
"practiceLocations": [
{
"address_1": "Msc 09 5040 1 University Of New Mexico",
"address_purpose": "LOCATION",
"city": "Albuquerque",
"state": "NM",
"postal_code": "871310001",
"country_code": "US",
"telephone_number": "505-272-6607",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SMITH",
"first_name": "CHRISTIAN",
"middle_name": "TYLER",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-04-15",
"last_updated": "2024-07-03",
"certification_date": "2024-07-03",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "NM",
"license": null,
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "NM",
"license": "DO2024-0037",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NM LICENSE",
"identifier": "DO2024-0037",
"state": "NM"
}
],
"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 Jul 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.