Active NPI
Dhara Pele
- Contractor
- Albuquerque, NM
National Provider Identifier
1992261218
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Contractor
- License
- MT8989
- Practice address
- 4600 Montgomery Blvd NE
Albuquerque, NM 87109-1210 - Phone
- (505) 727-4659
- NPI assigned
- Feb 11, 2019
- Last updated
- Feb 11, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Contractor | 171W00000X | MT8989 | NM | Primary |
Addresses
Primary practice location
4600 Montgomery Blvd NE
Albuquerque, NM 87109-1210
Mailing address
2 Trigo Rd
Placitas, NM 87043-8691
Phone (678) 876-6424
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 516062240 | Other | NM DRIVER'S LICENCE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MT8989 | NM | MD | Contractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1549843200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1549843200000",
"number": "1992261218",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2 TRIGO RD",
"city": "PLACITAS",
"state": "NM",
"postal_code": "870438691",
"telephone_number": "678-876-6424"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4600 MONTGOMERY BLVD NE",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871091210",
"telephone_number": "505-727-4659"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PELE",
"first_name": "DHARA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-02-11",
"last_updated": "2019-02-11",
"status": "A"
},
"taxonomies": [
{
"code": "171W00000X",
"taxonomy_group": "",
"desc": "Contractor",
"state": "NM",
"license": "MT8989",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NM DRIVER'S LICENCE",
"identifier": "516062240",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Albuquerque, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.