NPIMap

Individual provider Active NPI

Khadija Ahmad Mamsa, MD

  • Internal Medicine Physician
  • Carlsbad, NM
National Provider Identifier
1669744868
Registry record updated Aug 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD2013-0171 Issued in NM
Practice address
2420 W Pierce St
Suite 205
Carlsbad, NM 88220-3543
Phone
(575) 234-9692
Fax
(575) 887-5237
NPI assigned
Feb 2, 2012
Last updated
Aug 27, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD2013-0171 NM Primary

Addresses

Primary practice location

2420 W Pierce St
Suite 205
Carlsbad, NM 88220-3543

Mailing address

2420 W Pierce St Ste 205
Carlsbad, NM 88220-3518
Phone (575) 234-9692

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address khadija.mamsa.1@1739.direct.athenahealth.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130913000377 NM Practitioner - Internal Medicine 3274777222 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Southwest Medical Associates, LLCGroup PAC ID 7214831114, 326 clinicians

Practice addresses (Care Compare)

4420 Irving Blvd NW
Albuquerque, NM 87114-5915
Phone (505) 727-6300

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD2013-0171NMMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southwest Medical Associates, LLC CurrentSince Jul 1, 2022 Accepting new patients
Southwest Medical Associates, LLC CurrentSince Jul 1, 2022 Accepting new patients

Locations

4420 Irving Blvd NW
Albuquerque, NM 87114
Phone (505) 727-6300

6701 Jefferson St NE
Albuquerque, NM 87109
Phone (505) 727-0600

715 Martin Luther King Ave NE
Ste 301
Albuquerque, NM 87102
Phone (505) 727-4500

Interoperability endpoints

  • Direct secure messaging: khadija.mamsa.1@1739.direct.athenahealth.com
  • Direct secure messaging: kmamsa703647@ahs.direct-ci.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1328140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598486400000",
    "number": "1669744868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2420 W PIERCE ST STE 205",
            "city": "CARLSBAD",
            "state": "NM",
            "postal_code": "882203518",
            "telephone_number": "575-234-9692"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2420 W PIERCE ST",
            "address_2": "SUITE 205",
            "city": "CARLSBAD",
            "state": "NM",
            "postal_code": "882203543",
            "telephone_number": "575-234-9692",
            "fax_number": "575-887-5237"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAMSA",
        "first_name": "KHADIJA",
        "middle_name": "AHMAD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-02-02",
        "last_updated": "2020-08-27",
        "certification_date": "2020-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NM",
            "license": "MD2013-0171",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "khadija.mamsa.1@1739.direct.athenahealth.com",
            "affiliation": "N",
            "endpointDescription": "amr-direct address",
            "address_1": "2420 W Pierce St",
            "address_2": "Suite 205",
            "city": "Carlsbad",
            "state": "NM",
            "country_code": "US",
            "postal_code": "882203543",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Carlsbad, NM

Sources for this page

Verify at the official NPI Registry.