DR. JIMMIE R CHARLIE (M.D.) – Family Medicine Physician, NPI 1366523722
Family Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
999 FAMILY PRACTICE in NM
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Provider Addresses for DR. JIMMIE R CHARLIE (M.D.)
Santo Domingo Community Library, 134, Tesuque Street, Santo Domingo Pueblo / Kewa, Sandoval County, New Mexico, 87052, United States
SANTO DOMINGO PUEBLO, NM 870520340
Phone: (505) 465-3060
Fax: (505) 867-6527
Type: Mailing
Santo Domingo, Poblacion, San Joaquin, Iloilo, Western Visayas, Philippines
SANTO DOMINGO, NM 875020340
Phone: (505) 465-3060
Fax: (505) 465-3060
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2009-12-11
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20091211000706 | I | Family Practice | TX | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 115 | 49 | $0 |
| 99211 | Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional | 79 | 18 | $0 |
| 99348 | Residence visit for established patient with low level of medical decision making, per day, if using time, at least 30 minutes | 76 | 24 | $0 |
| 36415 | Insertion of needle into vein for collection of blood sample | 70 | 43 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 65 | 46 | $0 |
Insurance plans in this area (ZIP 87052)
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Provider's Procedures
Group practice members
| Name | Specialty | State |
|---|---|---|
| Clinical Psychologist | NM | |
| Nurse Practitioner | NM | |
| - | NM | |
| Qualified Audiologist | MN | |
| O P T O M E T R Y | MO | |
| Family Practice | NM | |
| P S Y C H I A T R Y | CA | |
| - | NM | |
| O P T O M E T R Y | NM | |
| - | AZ |
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