Mrs Diana M Nicolas, RD, CDE is a medicare enrolled "Nutritionist - Nutrition, Education" provider in Albuquerque, New Mexico. Her current practice location is
8300 Constitution Ave Ne Bld D, Albuquerque, New Mexico. You can reach out to her office (for appointments etc.) via phone at
(505) 559-6404.
Mrs Diana M Nicolas is licensed to practice in New Mexico (license number LD-1263) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1790257558.
Healthcare Provider's Profile
Full Name | Mrs Diana M Nicolas |
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Gender | Female |
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Speciality | Nutritionist - Nutrition, Education |
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Location | 8300 Constitution Ave Ne Bld D, Albuquerque, New Mexico |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1790257558
- Provider Enumeration Date: 12/18/2018
- Last Update Date: 01/14/2021
Medicare PECOS Information:
- PECOS PAC ID: 5395081376
- Enrollment ID: I20190111001616
Medical Identifiers
Medical identifiers for Mrs Diana M Nicolas such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1790257558 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
133V00000X | Dietitian, Registered | LD-1263 (New Mexico) | Secondary |
133NN1002X | Nutritionist - Nutrition, Education | LD-1263 (New Mexico) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Mrs Diana M Nicolas allows following entities to bill medicare on her behalf.
Provider Name | Presbyterian Healthcare Services |
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Provider Type | Part B Supplier - Clinic/group Practice |
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Provider Identifiers | NPI Number: 1104802354 PECOS PAC ID: 9234041708 Enrollment ID: O20031103000603 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mrs Diana M Nicolas is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Mrs Diana M Nicolas, RD, CDE 4252 Trinity Pl Nw, Albuquerque, NM 87107 Ph: (505) 850-8430 | Mrs Diana M Nicolas, RD, CDE 8300 Constitution Ave Ne Bld D, Albuquerque, NM 87110 Ph: (505) 559-6404 |
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