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SOPHOAN DAVIS
NPI 1003647942
Nurse Practitioner - Family in Albuquerque, NM

Active since August 12, 2024PECOS Enrolled
4010 MONTGOMERY BLVD NE, ALBUQUERQUE, NM 87109(505) 254-6100 Get Directions Write a Review

NPPES record last updated: June 29, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Sophoan Davis NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SOPHOAN DAVIS (NPI 1003647942) is an individual family provider in Albuquerque, New Mexico, licensed in New Mexico (61154) and active in the NPI registry since August 2024. She is enrolled in Medicare PECOS and is a graduate of Other (2024).

NPPES Registry Identity

NPI1003647942
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameSOPHOAN DAVIS
Location Address4010 MONTGOMERY BLVD NEAlbuquerque, NM 87109-1186
Mailing Address4010 Montgomery Blvd NeAlbuquerque, NM 87109-1186 · (505) 254-6100
Phone(505) 254-6100
Sole ProprietorYes
Medical School CMSOtherGraduated 2024
Enumeration DateAugust 12, 2024
Last NPPES UpdateJune 29, 2026
NPPES CertifiedJune 29, 2026
✔ NPI 1003647942 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in NM · 61154
4010 MONTGOMERY BLVD NE, Albuquerque, NM 87109
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Sophoan Davis is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID6709357445
PECOS Enrollment IDI20260603004623
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Sophoan Davis reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Optumcare New Mexico LLC
5.7 mi
Family Medicine
2901 TRANSPORT ST SE
Albuquerque, NM 87106
  • Reassigned Medicare billing, New Mexico enrollment
  • 104 clinicians in this Medicare group
NPI 1124053210 (505) 262-7000

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 87109 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$84.79 typical visit price
range $54.26 – $166.80
Typical copayment $21.19 (range $13.56 – $41.70)
Most-billed visit code 99203
Established Patient
$96.38 typical visit price
range $17.00 – $135.35
Typical copayment $24.09 (range $4.25 – $33.83)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 7

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MRS. NICOLE ANN BADILLO CNP
Nurse Practitioner (Women's Health)
4010 MONTGOMERY BLVD NE
ALBUQUERQUE, NM 87109
Bernalillo County (505) 254-6500
MYRRIA QUINTANA PA
Physician Assistant
4010 MONTGOMERY BLVD NE
ALBUQUERQUE, NM 87109
Bernalillo County (505) 275-4288
RODERICK MCVEETY MD
Family Medicine
4010 MONTGOMERY BLVD NE
ALBUQUERQUE, NM 87109
Bernalillo County (505) 254-6100
ANGEL TOLEDO
Nurse Practitioner
4010 MONTGOMERY BLVD NE
ALBUQUERQUE, NM 87109
Bernalillo County (505) 254-6100
JORGE SEDAS MD
Internal Medicine
4010 MONTGOMERY BLVD NE
ALBUQUERQUE, NM 87109
Bernalillo County (505) 254-6100
BRYAN A SANCHEZ
Nurse Practitioner (Family)
4010 MONTGOMERY BLVD NE
ALBUQUERQUE, NM 87109
Bernalillo County (505) 254-6100
CLARE A CASTIGLIA DO
Internal Medicine
4010 MONTGOMERY BLVD NE
ALBUQUERQUE, NM 87109
Bernalillo County (505) 888-8500

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Sophoan Davis's NPI number?

The NPI number for Sophoan Davis is 1003647942. It was assigned to this individual provider in the NPPES registry on August 12, 2024.

Where is Sophoan Davis located?

Sophoan Davis practices at 4010 Montgomery Blvd NE, Albuquerque, NM 87109. The listed phone number is (505) 254-6100.

What is Sophoan Davis's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Sophoan Davis enrolled in Medicare?

Yes. Sophoan Davis is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Sophoan Davis's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Sophoan Davis reassigns Medicare benefits to Optumcare New Mexico LLC (Albuquerque, NM). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Sophoan Davis's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Sophoan Davis was last updated on June 29, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.