Mariana Mejia Botero, MD is a medicare enrolled "Family Medicine" physician in Paraje, New Mexico. Her current practice location is
6 Basswood Rd, Paraje, New Mexico. You can reach out to her office (for appointments etc.) via phone at
(505) 431-0711.
Mariana Mejia Botero is licensed to practice in New Mexico (license number MD2016-0719) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1679893374.
Physician's Profile
| Full Name | Mariana Mejia Botero |
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| Gender | Female |
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| Speciality | Family Medicine |
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| Location | 6 Basswood Rd, Paraje, New Mexico |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1679893374
- Provider Enumeration Date: 06/03/2010
- Last Update Date: 04/19/2021
Medicare PECOS Information:
- PECOS PAC ID: 7012168354
- Enrollment ID: I20151022000116
Medical Identifiers
Medical identifiers for Mariana Mejia Botero such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
| 1679893374 | NPI | - | NPPES |
| H3451 | Medicaid | NM | |
| 78721016 | Medicaid | NM | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
| 207Q00000X | Family Medicine | MD2016-0719 (New Mexico) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Mariana Mejia Botero allows following entities to bill medicare on her behalf.
| Entity Name | Dhhs Phs Naihs Crownpoint Hospital |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1114960093 PECOS PAC ID: 0143128041 Enrollment ID: O20031230000393 |
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| Entity Name | Laguna Healthcare Corporation |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1962001024 PECOS PAC ID: 2365855079 Enrollment ID: O20210119000388 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mariana Mejia Botero is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
Mariana Mejia Botero, MD Po Box 549, Paraje, NM 87007-0549 Ph: (505) 431-0711 | Mariana Mejia Botero, MD 6 Basswood Rd, Paraje, NM 87007-1004 Ph: (505) 431-0711 |
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