Dawn R Back, PA is a medicare enrolled "Physician Assistant" in Santa Rosa, New Mexico. Her current practice location is
117 Camino De Vida, Suite 300, Santa Rosa, New Mexico. You can reach out to her office (for appointments etc.) via phone at
(575) 472-4311.
Dawn R Back is licensed to practice in New Mexico (license number PA2016-0044) 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 1841273554.
Provider's Profile
Full Name | Dawn R Back |
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Gender | Female |
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Speciality | Physician Assistant |
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Location | 117 Camino De Vida, Santa Rosa, 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: 1841273554
- Provider Enumeration Date: 11/28/2005
- Last Update Date: 02/08/2017
Medicare PECOS Information:
- PECOS PAC ID: 3173705357
- Enrollment ID: I20160901001267
Medical Identifiers
Medical identifiers for Dawn R Back such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1841273554 | NPI | - | NPPES |
54452015 | Medicaid | NM | |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
363A00000X | Physician Assistant | PA2016-0044 (New Mexico) | Primary |
363A00000X | Physician Assistant | 2103 (Alaska) | Secondary |
363A00000X | Physician Assistant | PA.0003777 (Colorado) | Secondary |
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. Dawn R Back 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 |
Dawn R Back, PA 117 Camino De Vida, Suite 300, Santa Rosa, NM 88435 Ph: (575) 472-4311 | Dawn R Back, PA 117 Camino De Vida, Suite 300, Santa Rosa, NM 88435 Ph: (575) 472-4311 |
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