Unknown Individual – Physician Assistant, NPI 1164517900
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
Loading map...
Provider Addresses for Unknown Individual
San Fidel, Cibola County, New Mexico, 87049, United States
SAN FIDEL, NM 870490130
Phone: (505) 552-5300
Fax: (505) 552-5805
Type: Mailing
Acoma-Canoncito-Laguna Service Unit, 80, Veterans Boulevard, North Acomita Village, Cibola County, New Mexico, 87034, United States
ACOMA, NM 87034
Phone: (505) 552-5300
Fax: (505) 552-5805
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
Loading prescription activity...
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.
No Medicare enrollment or revalidation data available for this provider in our database.
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 87049)
Loading plans...
Group practice members
| Name | Specialty | State |
|---|---|---|
| O P T O M E T R Y | NM | |
| - | NM | |
| Clinical Social Worker | NM | |
| O P T O M E T R Y | NM | |
| - | NM | |
| Diagnostic Radiology | MI | |
| Family Practice | NM | |
| - | OR | |
| Family Practice | NM | |
| Clinical Social Worker | NM |
Reviews
All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.
No reviews yet. Be the first to share your experience — your opinion helps families compare providers.