Individual provider Active NPI

Sara M Evans

  • Family Nurse Practitioner
  • Albuquerque, NM
National Provider Identifier
1750907713
Registry record updated Jan 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
60516 Issued in NM
Practice address
3901 Georgia St NE Ste B1
Albuquerque, NM 87110-1390
Phone
(505) 560-2517
NPI assigned
Jun 24, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 60516 NM Primary

Addresses

Primary practice location

3901 Georgia St NE Ste B1
Albuquerque, NM 87110-1390

Mailing address

3901 Georgia St NE Ste B1
Albuquerque, NM 87110-1390
Phone (505) 560-2517

Other identifiers 1

IdentifierTypeStateIssuer
45587515MedicaidNM

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200921001420 NM Practitioner - Nurse Practitioner 4183042351 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
60516NMMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Womens Specialists of New Mexico LTD CurrentSince Apr 21, 2022 Accepting new patients
Unm Hospital CurrentSince Aug 21, 2020 Accepting new patients
Unm Hospital CurrentSince Aug 21, 2020 Accepting new patients

Locations

400 Tijeras Ave NW
Ste 450
Albuquerque, NM 87102
Phone (505) 272-0148

7801 Academy Rd NE
Albuquerque, NM 87109
Phone (505) 272-2700

6320 Riverside Plaza Ln NW
Ste B
Albuquerque, NM 87120
Phone (505) 843-6168

6320 Riverside Plaza Ln NW
Ste A
Albuquerque, NM 87120
Phone (505) 843-6168

1001 Coal Ave SE
Albuquerque, NM 87106
Phone (505) 841-1001

4640 Jefferson Ln NE
Albuquerque, NM 87109
Phone (505) 843-6168

2211 Lomas Blvd NE
Unm, NM 87106
Phone (505) 272-1111

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1592956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706054400000",
    "number": "1750907713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3901 GEORGIA ST NE STE B1",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871101390",
            "telephone_number": "505-560-2517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3901 GEORGIA ST NE STE B1",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871101390",
            "telephone_number": "505-560-2517"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANS",
        "first_name": "SARA",
        "middle_name": "M",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-24",
        "last_updated": "2024-01-24",
        "certification_date": "2024-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NM",
            "license": "60516",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "45587515",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.