| Sage Specialty Care, Inc | |
|
7111 Prospect Pl Ne Ste D200 Albuquerque NM 87110-4309 | |
| (505) 369-7200 | |
| (505) 214-5701 |
| Full Name | Sage Specialty Care, Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 7111 Prospect Pl Ne Ste D200, Albuquerque, New Mexico |
| Authorized Official Name and Position | Catherine Soller (PRESIDENT) |
| Authorized Official Contact | 5868393356 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sage Specialty Care, Inc 7111 Prospect Pl Ne Ste D200 Albuquerque NM 87110-4309 Ph: (505) 369-7200 | Sage Specialty Care, Inc 7111 Prospect Pl Ne Ste D200 Albuquerque NM 87110-4309 Ph: (505) 369-7200 |
| NPI Number | 1629495494 |
|---|---|
| Provider Enumeration Date | 03/18/2014 |
| Last Update Date | 03/26/2019 |
| Medicare PECOS PAC ID | 5991923302 |
|---|---|
| Medicare Enrollment ID | O20140827000861 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629495494 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 03287932006 (New Mexico) | Primary |
| Provider Name | Elizabeth M Evans |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750341426 PECOS PAC ID: 4183612039 Enrollment ID: I20040501000064 |
| Provider Name | Catherine A Soller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528290558 PECOS PAC ID: 1658418132 Enrollment ID: I20100623001010 |
| Provider Name | Lita C Bailly |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306856166 PECOS PAC ID: 6800814237 Enrollment ID: I20120206000827 |
| Provider Name | Melissa Rose Pino |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598398216 PECOS PAC ID: 0143635987 Enrollment ID: I20210209001462 |
| Provider Name | William Sera |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679747646 PECOS PAC ID: 4587049705 Enrollment ID: I20220923000900 |
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