BABAK MIRIN M.D. NPI 1891776274

NPI Information

NPI: 1891776274
Provider Name: BABAK MIRIN, M.D.
Classification: Psychiatry & Neurology - 2084P0805X
Entity Type: Individual

Specialization: Geriatric Psychiatry

Organization: RUBEN A SUPAN LLC

PECOS Registration: Yes

Address:
405 W COUNTRY CLUB RD
ROSWELL, NM
ZIP 88201
Phone: (575) 622-8170
Get Directions

Babak Mirin, M.D. is a geriatric psychiatry psychiatry neurology in Roswell, NM with 28 years of experience. The provider is geriatric Psychiatry is a subspecialty with psychiatric expertise in prevention, evaluation, diagnosis and treatment of mental and emotional disorders in the elderly, and improvement of psychiatric care for healthy and ill elderly patients. Babak Mirin, M.D. NPI is 1891776274. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

405 W COUNTRY CLUB RD
ROSWELL, NM
ZIP 88201-209
Phone: (575) 622-8170

The NPI 1891776274 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 11/11/2005 and was last updated on 5/19/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	2084P0805X	Psychiatry & Neurology	Geriatric Psychiatry	20020076	NEW MEXICO	Yes
2	174400000X	Specialist		2002-0076	NEW MEXICO	No
3	2084A0401X	Psychiatry & Neurology	Addiction Medicine	20020076	NEW MEXICO	No

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	34876855	MEDICAID	NEW MEXICO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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