SOUTHWEST MEDICAL CLINIC INC
NPI 1144468075
Nurse Practitioner - Family in Bosque Farms, NM
About Southwest Medical Clinic Inc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
SOUTHWEST MEDICAL CLINIC INC (NPI 1144468075) is a healthcare organization registered as a family in Bosque Farms, New Mexico and active in the NPI registry since January 2009. The organization holds a CLIA Waiver certificate valid through May 31, 2027 and lists Fatemeh Mansoori, Owner/ Provider, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 3
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Southwest Medical Clinic Inc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by February 28, 2027
Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Southwest Medical Clinic Inc, which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Waiver 32D1100168
Southwest Medical Clinic Inc · Bosque Farms, NMFrequently 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 Southwest Medical Clinic Inc's NPI number?
The NPI number for Southwest Medical Clinic Inc is 1144468075. It was assigned to this organization in the NPPES registry on January 30, 2009.
Where is Southwest Medical Clinic Inc located?
Southwest Medical Clinic Inc is located at 2230 Bosque Farms Blvd, Bosque Farms, NM 87068. The listed phone number is (505) 869-0300.
What is Southwest Medical Clinic Inc's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is Southwest Medical Clinic Inc enrolled in Medicare?
Yes. Southwest Medical Clinic Inc is registered in the Medicare PECOS enrollment system.
When is Southwest Medical Clinic Inc's Medicare revalidation due?
According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (New Mexico, Clinic/Group Practice) is due for revalidation by February 28, 2027. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.
How many clinicians bill Medicare through Southwest Medical Clinic Inc?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Nurse Practitioner) reassigns their Medicare billing to Southwest Medical Clinic Inc. A 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 the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Southwest Medical Clinic Inc hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 32D1100168) is associated with this NPI, valid through May 31, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
When was this NPI record last updated?
The NPPES record for Southwest Medical Clinic Inc was last updated on May 26, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 years 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.
# Southwest Medical Clinic Inc · NPI 1144468075
Family organization in Bosque Farms, New Mexico. Organization record, active in the CMS NPPES registry since January 30, 2009.
## Identity
- **NPI:** 1144468075 (Entity type: Organization)
- **Enumerated:** January 30, 2009
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **Organization subpart:** No
- **Authorized official:** Fatemeh Mansoori, OWNER/ PROVIDER
## Practice location
- **Address:** 2230 BOSQUE FARMS BLVD, Bosque Farms, NM 87068-9334
- **Phone:** (505) 869-0300
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** February 28, 2027 (Non-DME Part B, New Mexico, Clinic/Group Practice) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 1 clinician (Nurse Practitioner) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** May 26, 2009
- **Other identifiers:** Medicare UPIN Q34901 (NM); Medicaid 25079310 (NM); Other 349531402 (NM)
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1144468075) · Data from the CMS NPPES public registry.