Individual provider Active NPI

Tracy L Sanchez, PA-C

  • Medical Physician Assistant
  • Albuquerque, NM
National Provider Identifier
1902094923
Registry record updated Jun 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA-2007-0024 Issued in NM
Practice address
801 Vassar Dr NE
Albuquerque, NM 87106-2725
Phone
(505) 248-4065
Fax
(505) 248-4093
NPI assigned
Oct 4, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 13, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA-2007-0024 NM Primary

Addresses

Primary practice location

801 Vassar Dr NE
Albuquerque, NM 87106-2725

Mailing address

801 Vassar Dr NE
Albuquerque, NM 87106-2725
Phone (505) 248-4065

Other practice location 1

Acoma Canoncito Laguna Indian Health Center
80B Veteran's Blvd
Acoma, NM 87034
Phone (505) 552-5300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20100226000783 TX Practitioner - Physician Assistant 2264577410 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Albuquerque Indian Health CenterGroup PAC ID 7719883164, 55 clinicians

Practice addresses (Care Compare)

801 Vassar Dr NE
Albuquerque, NM 87106-2725
Phone (505) 248-4000

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA-2007-0024NMMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Jicarilla IHS Pharmacy PastSince Mar 5, 2023 Accepting new patients

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": "1191456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686614400000",
    "number": "1902094923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 VASSAR DR NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871062725",
            "telephone_number": "505-248-4065",
            "fax_number": "505-248-4093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 VASSAR DR NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871062725",
            "telephone_number": "505-248-4065",
            "fax_number": "505-248-4093"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Acoma Canoncito Laguna Indian Health Center",
            "address_2": "80B Veteran's Blvd",
            "address_purpose": "LOCATION",
            "city": "Acoma",
            "state": "NM",
            "postal_code": "87034",
            "country_code": "US",
            "telephone_number": "505-552-5300",
            "fax_number": "505-552-5828",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SANCHEZ",
        "first_name": "TRACY",
        "middle_name": "L",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-10-04",
        "last_updated": "2023-06-13",
        "certification_date": "2023-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NM",
            "license": "PA-2007-0024",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.