DERMATOLOGY OF NEW MEXICO LLC
NPI 1104468438
Clinic/Center in Albuquerque, NM

NPI Status: Active since October 08, 2019

Contact Information

610 BROADWAY BLVD NE
ALBUQUERQUE, NM
ZIP 87102
Phone: (505) 225-2500
Fax: (505) 225-2025

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  • Organization
  • Clinic/Center
  • CLIA Number: 32D2177486
  • CLIA Cert. Type: Physician Office
  • CLIA Exp. Date: 01-04-2027

About DERMATOLOGY OF NEW MEXICO LLC

This page provides the complete NPI Profile along with additional information for Dermatology Of New Mexico Llc, a provider established in Albuquerque, New Mexico operating as a Clinic/center. The healthcare provider is registered in the NPI registry with number 1104468438 assigned on October 2019. The practitioner's primary taxonomy code is 261Q00000X. The provider is registered as an organization and their NPI record was last updated one year ago. The authorized official of this NPI record is Suraj2252500 Reddy Md (Ceo / Md)

NPI
1104468438
Provider Name
DERMATOLOGY OF NEW MEXICO LLC
Entity Type
Organization
Location Address
610 BROADWAY BLVD NE ALBUQUERQUE, NM 87102
Location Phone
(505) 225-2500
Location Fax
(505) 225-2025
Mailing Address
610 BROADWAY BLVD NE ALBUQUERQUE, NM 87102
Mailing Phone
(505) 225-2500
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
10-08-2019
Last Update Date
07-30-2025
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Clinic/Center

Taxonomy Code
261Q00000X
Type
Ambulatory Health Care Facilities
Taxonomy Description
A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

SURAJ2252500 REDDY MD

Authorized Official Title
CEO / MD
Authorized Official Phone
(505) 225-2500

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
32D2177486
Facility Type
Physician Office
Certificate Effective Date
January 05, 2025
Certificate Expiration Date
January 04, 2027
Laboratory Director
SURAJ G. REDDY
Certificate Type
Certificate of Compliance
Certificate Type Description
This CLIA certificate is issued to Dermatology Of New Mexico Llc after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements. This type of certificate is issued to laboratories that perform nonwaived (moderate and/or high complexity) testing.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1104468438, we treat the final digit (8) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 62. The final step is to find the difference between that total and the next multiple of ten (70 - 62 = 8).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
1
Unchanged
Pos 3
0
Doubled → 0
Pos 4
4
Unchanged
Pos 5
4
Doubled → 8
Pos 6
6
Unchanged
Pos 7
8
Doubled → 16 → 1 + 6
Pos 8
4
Unchanged
Pos 9
3
Doubled → 6
Check
8
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 0 → 0 4 → 8 8 → 16 → 7 3 → 6

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 1 + 0 + 4 + 8 + 6 + 1 + 6 + 4 + 6 + 24 = 62

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 62 is 70. The difference is the calculated check digit.

70 - 62 = 8
This NPI is valid
The calculated check digit is 8, which matches the last digit of 1104468438.

Other Providers at the Same Location


The following 15 providers are registered at the same or a nearby location.

Urology
610 BROADWAY BLVD NE
ALBUQUERQUE, NM 87102
Urology
610 BROADWAY BLVD NE
ALBUQUERQUE, NM 87102
Physician Assistant (Medical)
610 BROADWAY BLVD NE
ALBUQUERQUE, NM 87102
Clinical Nurse Specialist (Adult Health)
610 BROADWAY BLVD NE
ALBUQUERQUE, NM 87102
Nurse Practitioner (Family)
610 BROADWAY BLVD NE
ALBUQUERQUE, NM 87102
Specialist
610 BROADWAY BLVD NE
ALBUQUERQUE, NM 87102
Physician Assistant (Medical)
610 BROADWAY BLVD NE
ALBUQUERQUE, NM 87102
Dermatology
610 BROADWAY BLVD NE
ALBUQUERQUE, NM 87102
Dermatology
610 BROADWAY BLVD NE
ALBUQUERQUE, NM 87102
Urology
610 BROADWAY BLVD NE
ALBUQUERQUE, NM 87102
Urology
610 BROADWAY BLVD NE
ALBUQUERQUE, NM 87102
Urology
610 BROADWAY BLVD NE
ALBUQUERQUE, NM 87102
Physician Assistant (Medical)
610 BROADWAY BLVD NE
ALBUQUERQUE, NM 87102
Physician Assistant (Medical)
610 BROADWAY BLVD NE
ALBUQUERQUE, NM 87102
Physician Assistant
610 BROADWAY BLVD NE
ALBUQUERQUE, NM 87102

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1104468438, enumerated as an "organization" on October 08, 2019.

The provider is located at 610 BROADWAY BLVD NE ALBUQUERQUE, NM 87102 and the phone number is (505) 225-2500.

Clinic/Center with taxonomy code 261Q00000X.