Individual provider Active NPI

Christopher R Miera, MD

  • Family Medicine Physician
  • Albuquerque, NM
National Provider Identifier
1932293313
Registry record updated Jan 31, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
88-53 Issued in NM
Practice address
9101 Montgomery Blvd NE
Albuquerque, NM 87111-2405
Phone
(505) 275-4288
Fax
(505) 275-4203
NPI assigned
Oct 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2019

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 88-53 NM Primary

Addresses

Primary practice location

9101 Montgomery Blvd NE
Albuquerque, NM 87111-2405

Mailing address

PO Box 26028
Albuquerque, NM 87125-6028
Phone (505) 262-3135

Other practice location 1

3411 N 5th Ave Ste 209
Phoenix, AZ 85013-3812
Phone (602) 789-0344

Other identifiers 2

IdentifierTypeStateIssuer
00005843MedicaidNM
328742YR41OtherNMMEDICARE PTAN

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091231000123 NM Practitioner - Family Practice 3779624531 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
88.68 of 100Reported as group
Quality
82.35
Promoting interoperability
100
Improvement activities
40
Cost
76.6

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
88-53NMMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Presbyterian Healthcare Services Family Medicine CurrentSince Apr 22, 2019 Accepting new patients
Presbyterian Healthcare Services CurrentSince Apr 22, 2019 Accepting new patients
Optumcare Endoscopy Center New Mexico, LLC Past 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

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": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548892800000",
    "number": "1932293313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 26028",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871256028",
            "telephone_number": "505-262-3135",
            "fax_number": "505-232-1627"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9101 MONTGOMERY BLVD NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871112405",
            "telephone_number": "505-275-4288",
            "fax_number": "505-275-4203"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3411 N 5th Ave Ste 209",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850133812",
            "country_code": "US",
            "telephone_number": "602-789-0344",
            "fax_number": "602-789-8389",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MIERA",
        "first_name": "CHRISTOPHER",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2019-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NM",
            "license": "88-53",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00005843",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "328742YR41",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.