Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Michael Hennelly, MD

Individual provider Family Medicine Physician · NPI 1871553933

Michael Hennelly, MD is a Family Practice in Jemez Pueblo, New Mexico. Graduated from University of Missouri, Columbia School of Medicine in 1974, 52 years ago. Practices with Pueblo of Jemez, a 22-clinician group and accepts Medicare assignment. Licensed in New Mexico.

Years since qualifying
52
Trained at
University of Missouri, Columbia School of Medicine
Licensed in
NM
In the registry since
2006
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

110 Sheep Spgs
Jemez Pueblo, NM 87024-0279
Phone: (575) 834-7413
Fax: (575) 834-7517
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 75-167 (NM)

Record details

NPI number1871553933
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedMarch 24, 2006
Last updated in NPPESSeptember 25, 2024
Certification dateSeptember 25, 2024
Mailing addressPo Box 279, Jemez Pueblo, NM 87024-0279

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyFAMILY PRACTICE
Medical schoolUNIVERSITY OF MISSOURI, COLUMBIA SCHOOL OF MEDICINE
Graduated 1974 (52 years in practice)
Group practice Pueblo Of Jemez — 22 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations9 on file with Medicare

Other providers in Jemez Pueblo