John R. Vigil, MD, LLC – General Practice Physician

Key facts

NPI: 1992084008
Entity type: Organization (NPI type 2)
Primary specialty: General Practice Physician 208D00000X
License: 89-319 (NM)
Legal business name: JOHN R. VIGIL, MD, LLC
Practice address: 3900 Eubank Blvd NE Ste 18
Albuquerque, NM 87111-3427
Phone: (505) 884-3344
NPI assigned: Aug 6, 2011
Organization subpart: No

Authorized official

Name: Johnnie R Vigil
Title: Owner/MD
Phone: (505) 263-1422

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Paul E Romo, MD Addiction Psychiatry Physician · Albuquerque, NM · NPI 1306089313

Medicare reassignment Care Compare group NPD NM
Johnnie R Vigil, MD General Practice Physician · Albuquerque, NM · NPI 1285762377

Medicare reassignment Care Compare group NPD GENERAL PRACTICE · NM
Jonathon F Vigil, PA-C Physician Assistant · Castle Pines, CO · NPI 1326397829

Medicare reassignment Care Compare group NM
Roberto Aguero Blau, MD Family Medicine Physician · Silver City, NM · NPI 1538555461

Medicare reassignment NPD GENERAL PRACTICE · NM
Martin Manuel Alvarado, FNP Family Nurse Practitioner · Albuquerque, NM · NPI 1265094916

Medicare reassignment NPD NM
Hope Jessica Montoya, CNP Family Nurse Practitioner · Albuquerque, NM · NPI 1396355996

Medicare reassignment NPD NM
Jose Luis Gonzalez -Sanchez, M.D. Maternal & Fetal Medicine Physician · Albuquerque, NM · NPI 1942303417

NPD (past)

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA number	Laboratory	Certificate	Expires
32D2139041	John R Vigil 3900 Eubank Blvd NE Ste 12, Albuquerque, NM 87111	Certificate of waiver	Oct 29, 2027

Medicare participation

Medicare fee-for-service enrollment: Enrolled in NM

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
O20130729000607	NM	Part B Supplier - Clinic/Group Practice	9830330174	Receives reassigned benefits from 6 practitioners Practice locations: Albuquerque, NM; Las Cruces, NM

National Provider Directory

Locations

3900 Eubank Blvd NE
Albuquerque, NM 87111
Phone (505) 298-5522

3900 Eubank Blvd NE
Ste 12
Albuquerque, NM 87111
Phone (505) 294-6009

3150 Carlisle Blvd NE
Ste 106
Albuquerque, NM 87110
Phone (505) 633-8173

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
General Practice Physician Group: 193400000X SINGLE SPECIALTY GROUP	208D00000X	89-319	NM	Yes

Addresses

Primary practice location

3900 Eubank Blvd NE Ste 18
Albuquerque, NM 87111-3427

Mailing address

205 W Boutz Rd BLDG 1
Las Cruces, NM 88005-3259
Phone (575) 532-7000

Other providers in Albuquerque, NM

All providers in Albuquerque, NM · General Practice Physician in New Mexico

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 5, 2021. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.