Individual provider Active NPI

Mia Kristen Lozada, MD

  • Internal Medicine Physician
  • Gallup, NM
National Provider Identifier
1942435474
Registry record updated Mar 19, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A111814 Issued in CA
Practice address
516 E. Nizhoni Blvd.
Gallup, NM 87301-1337
Phone
(505) 722-1000
Fax
(505) 726-8557
NPI assigned
May 28, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 19, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A111814 CA Primary

Addresses

Primary practice location

516 E. Nizhoni Blvd.
Gallup, NM 87301-1337

Mailing address

P.O. Box 1337
Gallup, NM 87305-1337
Phone (505) 722-1000

Other identifiers 2

IdentifierTypeStateIssuer
83952314MedicaidNM
730176MedicaidAZ

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120917000434 TX Practitioner - Internal Medicine 3476738683 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Chicago, Pritzker School of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
DHHS,PHS,Naihs, Gallup Indian Medical CenterGroup PAC ID 3173436409, 179 clinicians

Practice addresses (Care Compare)

516 E Nizhoni Blvd
Gallup, NM 87301-5748
Phone (505) 722-1000

Hospital & facility affiliations

  • Gallup Indian Medical Center Hospital, Gallup, NM, CCN 320061
  • Rehoboth McKinley Christian Health Care Services Hospital, Gallup, NM, CCN 321313
  • Cibola General Hospital Hospital, Grants, NM, CCN 321308

Merit-based Incentive Payment System (MIPS)

Final score
78.18 of 100Reported as group
Quality
61.12
Improvement activities
40
Cost
81.87

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A111814CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
DHHS,PHS,Naihs, Gallup Indian Medical Center CurrentSince Aug 13, 2012 Accepting new patients
DHHS,PHS,Naihs,Gallup Indian Medical Center CurrentSince Aug 13, 2012 Accepting new patients

Locations

1900 Mark Ave
Gallup, NM 87301
Phone (505) 863-6894

516 E Nizhoni Blvd
Gallup, NM 87301
Phone (505) 722-1326

306 E Nizhoni Blvd
Gallup, NM 87301
Phone (505) 863-5754

3720 Church Rock St
Gallup, NM 87301
Phone (505) 722-2261

Organizations & group practices 2

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 3

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": "1243468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1426723200000",
    "number": "1942435474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 1337",
            "city": "GALLUP",
            "state": "NM",
            "postal_code": "873051337",
            "telephone_number": "505-722-1000",
            "fax_number": "505-726-8557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "516 E. NIZHONI BLVD.",
            "city": "GALLUP",
            "state": "NM",
            "postal_code": "873011337",
            "telephone_number": "505-722-1000",
            "fax_number": "505-726-8557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOZADA",
        "first_name": "MIA",
        "middle_name": "KRISTEN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-05-28",
        "last_updated": "2015-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A111814",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "83952314",
            "state": "NM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "730176",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gallup, NM

Sources for this page

Verify at the official NPI Registry.