NPIMap

Individual provider Active NPI

Angela Mi Kyung Jo, M.D., M.S.H.S.

  • Family Medicine Physician
  • Albuquerque, NM
National Provider Identifier
1881601813
Registry record updated Jun 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A76859 Issued in CA
Practice address
8200 Central Ave SE
Albuquerque, NM 87108-2408
Phone
(505) 272-5885
Fax
(505) 272-6308
NPI assigned
Aug 2, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A76859 CA Primary

Addresses

Primary practice location

8200 Central Ave SE
Albuquerque, NM 87108-2408

Mailing address

933 Bradbury Dr SE
Suite 2222
Albuquerque, NM 87106-4374
Phone (505) 272-3120

Other names 1

  • Mi Kyung Jo Other name

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
I20110518000694 NM Practitioner - Family PracticePractitioner - Preventive Medicine 6800830639 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Preventive Medicine
Education
Loma Linda University School of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Vincent HospitalGroup PAC ID 6608775135, 335 clinicians
Presbyterian Healthcare ServicesGroup PAC ID 9234041708, 1,390 clinicians

Practice addresses (Care Compare)

5501 Herrera Dr
A
Santa Fe, NM 87507-2684
Phone (505) 913-3233

5901 Harper Dr NE
Albuquerque, NM 87109-3587
Phone (505) 823-8888

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
76859CAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Presbyterian Healthcare Services Family Medicine CurrentSince Mar 9, 2019 Accepting new patients
Presbyterian Healthcare Services CurrentSince Mar 9, 2019 Accepting new patients
St Vincent Hospital Current Accepting new patients
St. Vincent Hospital Family Medicine CurrentSince May 9, 2022 Accepting new patients

Locations

5901 Harper Dr NE
Albuquerque, NM 87109
Phone (505) 823-8233

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

465 Saint Michaels Dr
Ste 200
Santa Fe, NM 87505
Phone (505) 995-4901

5501 Herrera Dr
Santa Fe, NM 87507
Phone (505) 913-3233

5501 Herrera Dr
#A
Santa Fe, NM 87507
Phone (505) 913-3233

4801 Beckner Rd
Santa Fe, NM 87507
Phone (505) 772-1234

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

Interoperability endpoints

  • Direct secure messaging: mjo111376@direct.phs.org
  • Direct secure messaging: mjo281688@christushealth.direct-ci.net

Organizations & group practices 5

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.

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": "1154476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1338940800000",
    "number": "1881601813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "933 BRADBURY DR SE",
            "address_2": "SUITE 2222",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871064374",
            "telephone_number": "505-272-3120",
            "fax_number": "505-272-8060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8200 CENTRAL AVE SE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871082408",
            "telephone_number": "505-272-5885",
            "fax_number": "505-272-6308"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JO",
        "first_name": "ANGELA",
        "middle_name": "MI KYUNG",
        "credential": "M.D., M.S.H.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-02",
        "last_updated": "2012-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A76859",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MI KYUNG",
            "last_name": "JO",
            "credential": "M.D., MS.HS",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.