THERESA A WEIDEMANN (FNP-BC) – Pediatric Nurse Practitioner, NPI 1154986040
Pediatric Nurse Practitioner
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Doctor Profile
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Profile Insights
NPPES metrics only — not quality of care.
2,370 NURSE PRACTITIONER in NM
Provider Addresses for THERESA A WEIDEMANN (FNP-BC)
6027 Ursa Ave NW
Albuquerque, NM 871143510
Phone: (505) 280-6052
Type: Location
Bradbury Drive Southeast, Albuquerque, Bernalillo County, New Mexico, 87106-5117, United States
ALBUQUERQUE, NM 871064375
Phone: (505) 272-3120
Fax: (505) 272-8060
Type: Mailing
933 Bradbury Dr SE Ste 2222
Albuquerque, NM 87106
Phone: (505) 272-3120
Fax: (505) 272-8060
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: 2019-11-13
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 |
|---|---|---|---|---|
| I20191113002193 | I | Nurse Practitioner | NM | 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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 87114)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Certified Registered Nurse Anesthetist (Crna) | NM | |
| - | NM | |
| Certified Registered Nurse Anesthetist (Crna) | NM | |
| Internal Medicine | NM | |
| G A S T R O E N T E R O L O G Y | NM | |
| G A S T R O E N T E R O L O G Y | NM | |
| - | NM | |
| Internal Medicine, Gastroenterology | NM | |
| G A S T R O E N T E R O L O G Y | NM | |
| Nurse Practitioner | NM |
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