Molina Healthcare of New Mexico

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

MOLINA HEALTHCARE OF NEW MEXICO

Practice address

400 Tijeras Ave NW
Albuquerque, NM 87102-3234

Phone

(888) 562-5441

NPI assigned

Oct 26, 2017

Organization subpart

Yes

Parent organization

MOLINA HEALTHCAREAs reported in NPPES

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

Authorized official

Name

Daniel Sorrells

Title

Plan President-MHNM

Phone

(888) 562-5442

Specialties & licenses 2

Addresses

Part of

Molina Healthcare

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

{
    "created_epoch": "1508976000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1508976000000",
    "number": "1649782962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 OCEANGATE STE 100",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908024317",
            "telephone_number": "888-562-5442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 TIJERAS AVE NW",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871023234",
            "telephone_number": "888-562-5441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOLINA HEALTHCARE OF NEW MEXICO",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MOLINA HEALTHCARE",
        "enumeration_date": "2017-10-26",
        "last_updated": "2017-10-26",
        "status": "A",
        "authorized_official_last_name": "SORRELLS",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_title_or_position": "PLAN PRESIDENT-MHNM",
        "authorized_official_telephone_number": "888-562-5442"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amirkasra Mojtahed
• Amirkaveh Mojtahed, MD
• Mokscare Family Medicine LLC
• Saba Molai
• Kelli Ann Moleres, RPH
• Molina Healthcare of New Mexico
• Molina Medical Group of New Mexico, PC
• Arden Elynn Molina-Cowden, SLP
• Leticia Molina-Landeros, LMSW
• Andres Molina

• Family Medicine Physician in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Family Medicine Physician in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2017; 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.