Oak Street Health Physicians Group Of New Mexico Llc - Medicare Primary Care in Albuquerque, NM

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Oak Street Health Physicians Group Of New Mexico Llc is a medicare enrolled primary clinic (Clinic/center - Primary Care) in Albuquerque, New Mexico. The current practice location for Oak Street Health Physicians Group Of New Mexico Llc is 4208 Central Ave Sw Ste G, Albuquerque, New Mexico. For appointments, you can reach them via phone at (505) 777-3001. The mailing address for Oak Street Health Physicians Group Of New Mexico Llc is Po Box 740018, Atlanta, Georgia and phone number is (773) 352-1515.

Oak Street Health Physicians Group Of New Mexico Llc is licensed to practice in * (Not Available) (license number ). The clinic also participates in the medicare program and its NPI number is 1134793151. This medical practice accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at (505) 777-3001.

Contact Information

Oak Street Health Physicians Group Of New Mexico Llc
4208 Central Ave Sw Ste G
Albuquerque
NM 87105-1695
(505) 777-3001
(505) 808-4977

Map and Direction


Primary Care Clinic Profile

Full NameOak Street Health Physicians Group Of New Mexico Llc
SpecialityClinic/Center
Location4208 Central Ave Sw Ste G, Albuquerque, New Mexico
Authorized Official Name and PositionDavid Fairchild (CMO)
Authorized Official Contact6172765349
Accepts Medicare InsuranceYes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Oak Street Health Physicians Group Of New Mexico Llc
Po Box 740018
Atlanta
GA 30374-0018

Ph: (773) 352-1515		Oak Street Health Physicians Group Of New Mexico Llc
4208 Central Ave Sw Ste G
Albuquerque
NM 87105-1695

Ph: (505) 777-3001

NPI Details:

NPI Number1134793151
Provider Enumeration Date05/14/2021
Last Update Date04/17/2025

Medicare PECOS Information:

Medicare PECOS PAC ID4981001096
Medicare Enrollment IDO20210916000169

Medical Identifiers

Medical identifiers for Oak Street Health Physicians Group Of New Mexico Llc such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1134793151NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207R00000XInternal Medicine (* (Not Available))Secondary
363L00000XNurse Practitioner (* (Not Available))Secondary
363LF0000XNurse Practitioner - Family (* (Not Available))Secondary
1041C0700XSocial Worker - Clinical (* (Not Available))Secondary
207Q00000XFamily Medicine (* (Not Available))Secondary
261QP2300XClinic/center - Primary Care (* (Not Available))Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Oak Street Health Physicians Group Of New Mexico Llc acts as a billing entity for following providers:
Provider NameFrances K Lopez-bushnell
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1508847567
PECOS PAC ID: 1456318328
Enrollment ID: I20041213000273
Provider NameMichael Chartrand
Provider TypePractitioner - General Practice
Provider IdentifiersNPI Number: 1851317192
PECOS PAC ID: 2163501677
Enrollment ID: I20090904000475
Provider NameClaudia Alfaro-andrick
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1932315975
PECOS PAC ID: 1951447457
Enrollment ID: I20091014000589
Provider NameAnita M Velasco
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1932430501
PECOS PAC ID: 8921139452
Enrollment ID: I20100628000780
Provider NameWill Kaufman
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1083820120
PECOS PAC ID: 0244386712
Enrollment ID: I20130222000249
Provider NameThomas Longley
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1245597970
PECOS PAC ID: 8921251091
Enrollment ID: I20150601001878
Provider NameScott T Bernhardt
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1710210760
PECOS PAC ID: 9931481660
Enrollment ID: I20170112002568
Provider NameBaudilio J Velez
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1023105632
PECOS PAC ID: 5890853600
Enrollment ID: I20170407001634
Provider NameFiliz Azize Smith
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1104814607
PECOS PAC ID: 2860554300
Enrollment ID: I20180501002727
Provider NameCassandra M Otero
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1487118824
PECOS PAC ID: 6204176886
Enrollment ID: I20190318002036
Provider NameBarbara Sue Gross
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1881246247
PECOS PAC ID: 9638407745
Enrollment ID: I20190828001438
Provider NameJennifer L Castro
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1831753508
PECOS PAC ID: 5597194357
Enrollment ID: I20200331001642
Provider NameLeyna Inberg
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1801255898
PECOS PAC ID: 9830498138
Enrollment ID: I20210119001771
Provider NameSamuel Tri
Provider TypePractitioner - Osteopathic Manipulative Medicine
Provider IdentifiersNPI Number: 1083935076
PECOS PAC ID: 5496054272
Enrollment ID: I20210119002088
Provider NameGriffin Myers
Provider TypePractitioner - Emergency Medicine
Provider IdentifiersNPI Number: 1871817643
PECOS PAC ID: 7719145127
Enrollment ID: I20210916000589
Provider NameMahmoud Ismail
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1326415365
PECOS PAC ID: 2769880640
Enrollment ID: I20211006003242
Provider NameStephen Sproul
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1427030451
PECOS PAC ID: 5991786386
Enrollment ID: I20220312000238
Provider NameCindy Callisto
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1649524612
PECOS PAC ID: 5496018202
Enrollment ID: I20221110001284
Provider NameShalada Cristal Creecy-gutierrez
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1336653906
PECOS PAC ID: 2860860673
Enrollment ID: I20221129002833
Provider NameNatalia Klusacek
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1497142285
PECOS PAC ID: 1759686660
Enrollment ID: I20221229001776
Provider NameJamie Tom
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1497290720
PECOS PAC ID: 3274806054
Enrollment ID: I20230511000765
Provider NameTherese A Moreno
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1477071611
PECOS PAC ID: 3678927878
Enrollment ID: I20230921002169
Provider NameAlyssa Marie Swisher
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1164206579
PECOS PAC ID: 4183079494
Enrollment ID: I20231005003514
Provider NameKaren Elaine Cardon
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1184866402
PECOS PAC ID: 0446549455
Enrollment ID: I20231221004145
Provider NameStacy Ali
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1255415451
PECOS PAC ID: 8921041542
Enrollment ID: I20240116003540
Provider NameJose Basaldua
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1588931935
PECOS PAC ID: 8628412962
Enrollment ID: I20240214004452
Provider NameRebecca Murray
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1134557473
PECOS PAC ID: 2365675451
Enrollment ID: I20240314001588
Provider NameBelinda Ann Burden
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1609364934
PECOS PAC ID: 1052656154
Enrollment ID: I20240516002433
Provider NameMichelle Berger
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1033823497
PECOS PAC ID: 1658819941
Enrollment ID: I20240819000094
Provider NameShannon Krop
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1104393347
PECOS PAC ID: 4082956172
Enrollment ID: I20241002001315
Provider NameMiglena Garkova
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1447978887
PECOS PAC ID: 4082090329
Enrollment ID: I20250506002908

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Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.