Evolve Abq Professional Corporation

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

EVOLVE ABQ PROFESSIONAL CORPORATION

Practice address

4550 Eubank Blvd NE Ste 107
Albuquerque, NM 87111-2565

Phone

(505) 616-0915

NPI assigned

Jul 18, 2025

Last updated

Feb 4, 2026By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Lida Fatemi, DONPI 1295001048

Title

Practitioner

Phone

(404) 272-6088

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NM

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Lida Fatemi, D.O.

  • Internal Medicine Physician
  • Albuquerque, NM
  • NPI 1295001048
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1752796800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1770163200000",
    "number": "1952293466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4550 EUBANK BLVD NE STE 108",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871112565",
            "telephone_number": "505-485-2545",
            "fax_number": "505-657-7309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4550 EUBANK BLVD NE STE 107",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871112565",
            "telephone_number": "505-616-0915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVOLVE ABQ PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-07-18",
        "last_updated": "2026-02-04",
        "certification_date": "2026-02-04",
        "status": "A",
        "authorized_official_last_name": "FATEMI",
        "authorized_official_first_name": "LIDA",
        "authorized_official_title_or_position": "PRACTITIONER",
        "authorized_official_telephone_number": "404-272-6088",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Primary Care Clinic/Center in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Primary Care Clinic/Center in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.