Individual provider Active NPI

Michelle Valentine, DO

  • Internal Medicine Physician
  • Albuquerque, NM
National Provider Identifier
1669835021
Registry record updated Jan 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A-2287-19 Issued in NM
Practice address
601 Dr Martin Luther King Jr Ave NE
Albuquerque, NM 87102-3619
Phone
(505) 727-8360
Fax
(505) 727-8768
NPI assigned
Apr 3, 2016
Last updated
Jan 23, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 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 A-2287-19 NM Primary

Addresses

Primary practice location

601 Dr Martin Luther King Jr Ave NE
Albuquerque, NM 87102-3619

Mailing address

10111 Inverness Main St Unit 405
Englewood, CO 80112-5726
Phone (720) 475-6904

Other practice location 1

1125 N College Ave # Slot100
Fayetteville, AR 72703-1908
Phone (720) 475-6904

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191114002430 NM Practitioner - Internal Medicine 3072802404 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A-2287-19NMMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southwest Medical Associates, LLC CurrentSince Nov 1, 2019 Accepting new patients
Southwest Medical Associates, LLC CurrentSince Nov 1, 2019 Accepting new patients

Locations

4101 Indian School Rd NE
Ste 110
Albuquerque, NM 87110
Phone (505) 727-8360

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

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.

NPI Registry JSON

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

{
    "created_epoch": "1459641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579737600000",
    "number": "1669835021",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10111 INVERNESS MAIN ST UNIT 405",
            "city": "ENGLEWOOD",
            "state": "CO",
            "postal_code": "801125726",
            "telephone_number": "720-475-6904"
        },
        {
            "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",
            "fax_number": "505-727-8768"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1125 N College Ave # Slot100",
            "address_purpose": "LOCATION",
            "city": "Fayetteville",
            "state": "AR",
            "postal_code": "727031908",
            "country_code": "US",
            "telephone_number": "720-475-6904",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VALENTINE",
        "first_name": "MICHELLE",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-03",
        "last_updated": "2020-01-23",
        "certification_date": "2020-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NM",
            "license": "A-2287-19",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.