Albuquerque Indian Health Center
Organization Active NPI Clinic/Center · Albuquerque, NM
NPI 1659458917 · NPPES record last updated Feb 7, 2025
Key facts
- NPI
- 1659458917
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Clinic/Center 261Q00000X
- Legal business name
- ALBUQUERQUE INDIAN HEALTH CENTER
- Practice address
- 801 Vassar Dr NE
Albuquerque, NM 87106-2725 - Phone
- (505) 248-4062
- Fax
- (505) 248-4093
- NPI assigned
- Nov 1, 2006
- Organization subpart
- No
Authorized official
- Name
- Darrell Miller
- Title
- Chief Executive Officer
- Phone
- (505) 248-7773
Subparts reporting this organization as parent 3
Practitioners 149
-
Chaunte Latrael Abe, APRN-CNP, FNP-C
-
Chelsea Marie Cook, PMHNP
-
Marissa D Cortes Mendez, CNM, CNP
-
Kate Collins Faber, FNP
-
Thomas Faber, MD
-
Melinda Rose Frank, LCSW
-
Vincent Goodman, OD
-
Miranda C Haley, M.D.
-
Kathryn McClain, DO
-
Jasper Lynn McKay, LCSW
-
Phuong M Nguyen, MD
-
Nicole Nolan, MD
-
Olatoke M Oke, MD
-
Damon Lee Brooks, D.O.
-
Joel A. Di Santi, DPM
-
Jeremy Scott Fullingim, D.O.
-
Shawn D Grant, MD
-
Kimberlee A Kali, LCSW/LISW
-
Julia Dry Knarreborg, M.D.
-
Sarah Mariano Llanque, ARNP
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20031208001026 | TX | Part B Supplier - Clinic/Group Practice | 7719883164 |
Receives reassigned benefits from 146 practitioners Practice locations: Albuquerque, NM |
National Provider Directory
Locations
5300 Homestead Rd NE
Albuquerque, NM 87110
Phone (505) 248-4901
2 Dove Rd
#C
Bernalillo, NM 87004
Phone (505) 867-2497
2220 Grande Blvd SE
Rio Rancho, NM 87124
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinic/Center | 261Q00000X | Yes |
Addresses
Primary practice location
801 Vassar Dr NE
Albuquerque, NM 87106-2725
Mailing address
PO Box 95443
Cleveland, OH 44101-0033
Phone (505) 248-7771
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| H7890 | Medicaid | NM |
Other providers in Albuquerque, NM
- Albuquerque Healthcare for the Homeless
- Albuquerque Heights Healthcare and Rehabilitation Center, LLC
- Albuquerque I.H.S. Dental Clinic
- Albuquerque Implant & Periodontal Consultants. LLC
- Albuquerque Indian Center, Inc
- Albuquerque Indian Health Center Pharmacy
- Albuquerque Indian Health Pharmacy
- Albuquerque Integrative Medicine LLC
- Albuquerque Internal Medicine LLC
- Albuquerque Meals on Wheels, Inc
All providers in Albuquerque, NM · Clinic/Center in New Mexico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 7, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.