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DR. JIMMIE R CHARLIE M.D.
NPI 1366523722
Family Medicine in Santo Domingo, NM

Active since October 18, 2006PECOS EnrolledAccepts Medicare Assignment
85 WEST HIGHWAY 22, SANTO DOMINGO, NM 87502(505) 465-3060(505) 465-3060 Get Directions Write a Review

NPPES record last updated: September 2, 2016. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Dr. Jimmie R Charlie M.d. NPPES

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

DR. JIMMIE R CHARLIE M.D. (NPI 1366523722) is an individual family medicine provider in Santo Domingo, New Mexico, licensed in New Mexico (20020019) and active in the NPI registry since October 2006. He is enrolled in Medicare PECOS and is a graduate of Stanford University School Of Medicine (1998).

NPPES Registry Identity

NPI1366523722
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameDR. JIMMIE R CHARLIECredential: M.D.
Location Address85 WEST HIGHWAY 22Santo Domingo, NM 87502-0340
Mailing AddressPo Box 340Santo Domingo Pueblo, NM 87052-0340 · (505) 465-3060 · Fax (505) 867-6527
Phone(505) 465-3060
Fax(505) 465-3060
Sole ProprietorNo
Medical School CMSStanford University School Of MedicineGraduated 1998
Enumeration DateOctober 18, 2006
Last NPPES UpdateSeptember 2, 2016
✔ NPI 1366523722 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in NM · 20020019
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
85 WEST HIGHWAY 22, Santo Domingo, NM 87502
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Other Identifiers 2

Medicaid85534862NM
Medicare UPINH69306NM

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Jimmie R Charlie M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID7911047543
PECOS Enrollment IDI20091211000706
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 Reassignments

2

Medicare enrollment records show Jimmie Charlie reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Kewa Pueblo Health Corporation
3.8 mi
Federally Qualified Health Center (FQHC)
85 W HIGHWAY 22
Santo Domingo Pueblo, NM 87052
  • Reassigned Medicare billing, Texas enrollment
  • 52 clinicians in this Medicare group
NPI 1467739888 (505) 465-3060
Haaku Health
76 mi
Health Service
80 B VETERANS BLVD
San Fidel, NM 87049
  • Reassigned Medicare billing, Texas enrollment
  • 22 clinicians in this Medicare group
NPI 1962384438 (505) 280-7200

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

Areas of Expertise CMS Part B claims 10

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
100 services42 patients
Residence visit for established patient with low level of medical decision making, per day, if using time, at least 30 minutes 99348
An established patient home visit is a 25-minute appointment where a healthcare provider visits you at your home. This service is for patients who have previously been seen by the provider. It includes a check-up and discussion about your health concerns.
63 services13 patients
Blood glucose (sugar) test performed by hand-held instrument 82962
A blood glucose test uses a handheld device to measure the amount of sugar in your blood. A small prick on your finger allows a drop of blood to be placed on a test strip, which is then read by the device. This helps monitor and manage diabetes effectively.
49 services27 patients
Hemoglobin a1c level 83036
Hemoglobin A1c (HbA1c) is a test that measures your average blood sugar level over the past 2-3 months. It's used to monitor how well diabetes is being controlled. High levels may indicate that your diabetes treatment plan needs adjustment.
44 services29 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
37 services28 patients
Administration of influenza virus vaccine G0008
The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.
36 services36 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 87502 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.

Referred Medical Equipment & Supplies CMS DME claims 3

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431
DME-Oxygen and Supplies · category DC000N
4 suppliers46 claims46 services$14.01 avg. paid by Medicare
Stationary oxygen contents, liquid, 1 month's supply = 1 unit E0442
DME-Oxygen and Supplies · category DC000N
1 supplier12 claims12 services$43.13 avg. paid by Medicare
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390
DME-Oxygen and Supplies · category DC002N
4 suppliers46 claims46 services$68.74 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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 Jimmie Charlie's NPI number?

The NPI number for Jimmie Charlie is 1366523722. It was assigned to this individual provider in the NPPES registry on October 18, 2006.

Where is Jimmie Charlie located?

Jimmie Charlie practices at 85 West Highway 22, Santo Domingo, NM 87502. The listed phone number is (505) 465-3060.

What is Jimmie Charlie's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Jimmie Charlie enrolled in Medicare?

Yes. Jimmie Charlie is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Jimmie Charlie's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jimmie Charlie reassigns Medicare benefits to 2 organizations: Kewa Pueblo Health Corporation (Santo Domingo Pueblo, NM) and Haaku Health (San Fidel, NM). Each 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 Jimmie Charlie'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 Jimmie Charlie was last updated on September 2, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.