NPIMap

Individual provider Active NPI

Darcy C Cooke, PA-C

  • Surgical Physician Assistant
  • Albuquerque, NM
National Provider Identifier
1790870970
Registry record updated Apr 6, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA2003-0015 Issued in NM
Practice address
4701 Montgomery Blvd NE
Lovelace Medical Group Breast Care Center
Albuquerque, NM 87109-1219
Phone
(505) 727-6900
Fax
(505) 727-6913
NPI assigned
Oct 4, 2006
Last updated
Apr 6, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X PA2003-0015 NM Primary

Addresses

Primary practice location

4701 Montgomery Blvd NE
Lovelace Medical Group Breast Care Center
Albuquerque, NM 87109-1219

Mailing address

4701 Montgomery Blvd NE
Breast Care Center
Albuquerque, NM 87109-1219
Phone (505) 727-6900

Other identifiers 1

IdentifierTypeStateIssuer
2535033MedicaidNM

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
I20060215000708 NM Practitioner - Physician Assistant 0446203244 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2003
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)

320 Seven Springs Way
Suite 100
Brentwood, TN 37027-5697

340 Seven Springs Way
Suite 100
Brentwood, TN 37027-5697

4701 Montgomery Blvd NE
Albuquerque, NM 87109-1219
Phone (505) 727-7800

4705 Montgomery Blvd NE
Suite 101
Albuquerque, NM 87109-1246
Phone (505) 727-6971

715 Dr Martin Luther King Jr Ave NE
Suite 301
Albuquerque, NM 87102-3668
Phone (505) 727-7090

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Southwest Medical Associates, LLC CurrentSince Dec 14, 2020 Accepting new patients
Unm Medical Group, Inc. CurrentSince Mar 18, 2016 Accepting new patients
Southwest Medical Associates, LLC CurrentSince Dec 14, 2020 Accepting new patients

Locations

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

4701 Montgomery Blvd NE
Albuquerque, NM 87109
Phone (505) 727-2000

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

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

Interoperability endpoints

  • Direct secure messaging: dcooke327441@ahs.direct-ci.com

Organizations & group practices 4

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 5

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": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459900800000",
    "number": "1790870970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4701 MONTGOMERY BLVD NE",
            "address_2": "BREAST CARE CENTER",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871091219",
            "telephone_number": "505-727-6900",
            "fax_number": "505-727-6913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4701 MONTGOMERY BLVD NE",
            "address_2": "LOVELACE MEDICAL GROUP BREAST CARE CENTER",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871091219",
            "telephone_number": "505-727-6900",
            "fax_number": "505-727-6913"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOKE",
        "first_name": "DARCY",
        "middle_name": "C",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-04",
        "last_updated": "2016-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NM",
            "license": "PA2003-0015",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2535033",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.