Northern New Mexico Health Care, LLC
NPI 1861535825ActiveOrganization· Specialist· Espanola, NM
Specialist in Espanola, New Mexico, registered in NPPES in February 2007. The authorized official on file is Jonathan Karl Frederiksen, President-Owner. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1861535825 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Feb 15, 2007 |
| Last updated in NPPES | Jun 22, 2026 |
| Certified by provider | Jun 22, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Specialist Primary | 174400000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (NM) |
|---|
Other Specialist providers in Espanola
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- 1801905377