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SPECIALTY CARE CLINIC LLC
NPI 1699517771
Family Medicine in Albuquerque, NM

Active since June 10, 2024
3825 EUBANK BLVD NE STE H, ALBUQUERQUE, NM 87111(505) 350-3397(505) 323-7980 Get Directions Write a Review

NPPES record last updated: October 7, 2024. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Oct 7, 2024, Oct 2, 2024, Jun 13, 2024 (3 updates tracked since 2024).

About Specialty Care Clinic Llc NPPES

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

SPECIALTY CARE CLINIC LLC (NPI 1699517771) is a healthcare organization registered as a family medicine in Albuquerque, New Mexico and active in the NPI registry since June 2024. The organization lists John K Jain, Owner Ceo, as its authorized official.

NPPES Registry Identity

NPI1699517771
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameSPECIALTY CARE CLINIC LLC
Location Address3825 EUBANK BLVD NE STE HAlbuquerque, NM 87111-3559
Mailing Address3825 Eubank Blvd Ne Ste HAlbuquerque, NM 87111-3559 · (505) 350-3397 · Fax (505) 323-7980
Phone(505) 350-3397
Fax(505) 323-7980
Organization SubpartNo
Authorized OfficialJohn K JainOwner Ceo · (505) 350-3397
Enumeration DateJune 10, 2024
Last NPPES UpdateOctober 7, 20243 updates tracked since enumeration
NPPES CertifiedOctober 7, 2024
✔ NPI 1699517771 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
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.
Also ListedClinic/Center · Multi-SpecialtyTaxonomy 261QM1300X
3825 EUBANK BLVD NE STE H, Albuquerque, NM 87111
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Specialty Care Clinic Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

3

Medicare enrollment records show 3 clinicians reassign Medicare billing to Specialty Care Clinic LLC, which bills Medicare for the services they deliver. Of these, 1 practice at this address. They are listed nearest first.

Clinicians, nearest first (3)

Chandran Vedamanikam, M.D.
Family Practice
NPI 1154585990
3825 EUBANK BLVD NE STE H
Albuquerque, NM 87111
(505) 350-3397
✔ PECOS✔ Accepts MedicareSame address
Sarah Pack, MBA, MSN, FNP-BC
Nurse Practitioner
NPI 1841853876
1415 NORTHWEST BYP STE 2
Great Falls, MT 59404
(406) 788-6300
✔ PECOS✔ Accepts Medicare890 mi
Julie Quinonez, CERTIFIED NURSE PRAC
Nurse Practitioner
NPI 1124277181
2410 CALIFORNIA ST
San Francisco, CA 94115
(888) 663-6331
✔ PECOS✔ Accepts Medicare903 mi

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

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 Specialty Care Clinic LLC's NPI number?

The NPI number for Specialty Care Clinic LLC is 1699517771. It was assigned to this organization in the NPPES registry on June 10, 2024.

Where is Specialty Care Clinic LLC located?

Specialty Care Clinic LLC is located at 3825 Eubank Blvd NE Ste H, Albuquerque, NM 87111. The listed phone number is (505) 350-3397.

What is Specialty Care Clinic LLC's specialty?

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

Is Specialty Care Clinic LLC enrolled in Medicare?

Yes. Specialty Care Clinic LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Specialty Care Clinic LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 3 clinicians reassign their Medicare billing to Specialty Care Clinic LLC, in Family Practice and Nurse Practitioner. 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. Of these, 1 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Specialty Care Clinic LLC was last updated on October 7, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.