Individual provider Active NPI

Mikayla Storm Isassi, NP

  • Family Nurse Practitioner
  • Albuquerque, NM
National Provider Identifier
1780377135
Registry record updated May 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
00000 Issued in NM
Practice address
11501 Montgomery Blvd NE
Albuquerque, NM 87111-2796
Phone
(505) 814-1333
NPI assigned
May 31, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 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 00000 NM Primary

Addresses

Primary practice location

11501 Montgomery Blvd NE
Albuquerque, NM 87111-2796

Mailing address

8109 Westover PL NW
Albuquerque, NM 87120-5527
Phone (505) 250-8494

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
I20240108003772 NM Practitioner - Nurse Practitioner 9931550688 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Presbyterian Healthcare ServicesGroup PAC ID 9234041708, 1,390 clinicians

Practice addresses (Care Compare)

3436 Isleta Blvd SW
Albuquerque, NM 87105-5837
Phone (505) 462-7777

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
00000NMMDCase Manager/Care Coordinator

Practice roles

OrganizationSpecialtyStatusNew patients
Presbyterian Healthcare Services CurrentSince May 1, 2024 Accepting new patients
Presbyterian Healthcare Services CurrentSince May 1, 2024 Accepting new patients
Presbyterian Healthcare Services Past Accepting new patients

Locations

3436 Isleta Blvd SW
Albuquerque, NM 87105
Phone (505) 462-7777

8300 Constitution Ave NE
Bldg D
Albuquerque, NM 87110
Phone (505) 291-2200

7400 Menaul Blvd NE
Albuquerque, NM 87110
Phone (505) 596-2400

2200 W 21st St
Clovis, NM 88101
Phone (505) 769-7577

Interoperability endpoints

  • Direct secure messaging: misassi248879@direct.phs.org
  • Direct secure messaging: mikayla.isassi.1@32307.direct.athenahealth.com

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": "1685491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715731200000",
    "number": "1780377135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8109 WESTOVER PL NW",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871205527",
            "telephone_number": "505-250-8494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11501 MONTGOMERY BLVD NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871112796",
            "telephone_number": "505-814-1333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ISASSI",
        "first_name": "MIKAYLA",
        "middle_name": "STORM",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-31",
        "last_updated": "2024-05-15",
        "certification_date": "2023-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NM",
            "license": "00000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.