Clarissa Garcia, NP
Individual provider Active NPI Family Nurse Practitioner · Mora, NM
NPI 1740949049 · NPPES record last updated Dec 14, 2021
Key facts
- NPI
- 1740949049
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 65836 (NM)
- Practice address
- 3 Mora Valley Clinic Rd
Mora, NM 87732-2202 - Phone
- (575) 387-5069
- NPI assigned
- Dec 14, 2021
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 4
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Sunrise Clinics
Practice addresses (Care Compare)
117 Camino de Vida
Suite 300
Santa Rosa, NM 88435-2267
Phone (575) 472-4311
2515 Ridge Runner Rd
Las Vegas, NM 87701-4972
Phone (505) 434-0119
901 Baca St
Las Vegas, NM 87701-4972
Phone (505) 454-3218
Hospital & facility affiliations
- Christus St Vincent Regional Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NM
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220215000791 | NM | Practitioner - Nurse Practitioner | 3375936305 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 65836 | NM | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sunrise Clinics | Current |
Accepting new patients | |
| Sunrise Clinics | Past | Accepting new patients | |
| Taos Health Systems, Inc., Holy Cross Hospital | Past | Accepting new patients |
Locations
2515 Ridge Runner Rd
Las Vegas, NM 87701
Phone (505) 425-2662
901 Baca St
Las Vegas, NM 87701
Phone (505) 454-3218
1024 S Pacific St
Las Vegas, NM 87701
Phone (505) 426-2564
117 Camino de Vida
Ste 300
Santa Rosa, NM 88435
Phone (575) 472-4311
717 S 3rd St
Santa Rosa, NM 88435
Phone (505) 426-2262
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 65836 | NM | Yes |
Addresses
Primary practice location
3 Mora Valley Clinic Rd
Mora, NM 87732-2202
Mailing address
PO Box 209
Mora, NM 87732-0209
Phone (575) 387-5069
Other providers in Mora, NM
- County of Mora Board of County Commissioners
- Consuelo Cruz
- Nathan Christopher Duran
- Devon Denise Fox
- William Fresquez
- Shantel Garcia
- Helping Hands Inc.
- Tanya Johnson
- Kids Counseling, Inc
- Michael J. Lee
All providers in Mora, NM · Family Nurse Practitioner 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 Dec 14, 2021. 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.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.