Lisa Anne Ethridge, in Albuquerque, NM - Medicare Nurse Practitioner

Lisa Anne Ethridge, is a medicare enrolled "Nurse Practitioner - Family" in Albuquerque, New Mexico. She graduated from nursing school in 2019 and has 5 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Espanola Sports Medicine Pa, St. Vincent Hospital and her current practice location is 1625 Rio Bravo Blvd Sw Ste 36, Albuquerque, New Mexico. You can reach out to her office (for appointments etc.) via phone at (505) 777-3004.

Lisa Anne Ethridge is licensed to practice in New Mexico (license number 57020) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1467005140.

Contact Information

	Lisa Anne Ethridge,
	1625 Rio Bravo Blvd Sw Ste 36, Albuquerque, NM 87105-6060
	(505) 777-3004
	Not Available

Map and Direction

Provider's Profile

Full Name	Lisa Anne Ethridge
Gender	Female
Speciality	Nurse Practitioner
Experience	5 Years
Location	1625 Rio Bravo Blvd Sw Ste 36, Albuquerque, New Mexico
Accepts Medicare Assignments	Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.

Medical Education and Training:

Lisa Anne Ethridge graduated from nursing school in 2019

NPI Data:

NPI Number: 1467005140
Provider Enumeration Date: 07/22/2019
Last Update Date: 12/28/2022

Medicare PECOS Information:

PECOS PAC ID: 2062744428
Enrollment ID: I20191105000140

Medical Identifiers

Medical identifiers for Lisa Anne Ethridge such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1467005140	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LF0000X	Nurse Practitioner - Family	57020 (New Mexico)	Primary

Medical Facilities Affiliation

Facility Name	Location	Facility Type
Christus St Vincent Regional Medical Center	Santa fe, NM	Hospital

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Espanola Sports Medicine Pa	2163691411	52
St. Vincent Hospital	6608775135	271

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. Lisa Anne Ethridge allows following entities to bill medicare on her behalf.

Entity Name	Presbyterian Healthcare Services
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1104802354 PECOS PAC ID: 9234041708 Enrollment ID: O20031103000603

Entity Name	St. Vincent Hospital
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1578587150 PECOS PAC ID: 6608775135 Enrollment ID: O20040105000372

Entity Name	Bella Vida Health Care And Medi Spa
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1568704237 PECOS PAC ID: 6507092327 Enrollment ID: O20131126000443

Entity Name	Newmexidoc Pa
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1316358989 PECOS PAC ID: 6204150659 Enrollment ID: O20150113002432

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. Lisa Anne Ethridge 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
Lisa Anne Ethridge, Po Box 740018, Atlanta, GA 30374-0018 Ph: (773) 759-7550	Lisa Anne Ethridge, 1625 Rio Bravo Blvd Sw Ste 36, Albuquerque, NM 87105-6060 Ph: (505) 777-3004

Reviews and Comments

Nurse Practitioner Nurses in Albuquerque, NM

Mrs. Kristell L Michael, APN Nurse Practitioner Medicare: Medicare Enrolled Practice Location: Us Air Force 377 Mdg/sghc 2050a Second Street Se, Albuquerque, NM 87117 Phone: 505-846-3562 Fax: 334-953-8607
Mr. Michael Alan Wallace, CNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 8210 Louisiana Blvd Ne, Suite C, Albuquerque, NM 87113 Phone: 505-858-1222 Fax: 505-858-1224
Ms. Maureen Kolomeir, RN, CNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 5345 Wyoming Blvd, Suite 101, Albuquerque, NM 87109 Phone: 505-856-6898 Fax: 505-292-1574
Patricia J Miller, PMHNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: Care Campus, 5901 Zuni Rd Se, Albuquerque, NM 87108 Phone: 505-321-4269
Mrs. Jessika Junick, NP-C Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 3825 Eubank Blvd Ne Ste A, Albuquerque, NM 87111 Phone: 505-292-8575 Fax: 505-292-8409
Phyllis Annette Ingham, NP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1100 Lead Ave Se, Albuquerque, NM 87106 Phone: 505-224-7000
Debra Vaccaro, FNP-C Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 3500 Comanche Rd Ne Ste C, Albuquerque, NM 87107 Phone: 505-998-7200 Fax: 505-998-7220

Lisa Anne Ethridge, - Medicare Nurse Practitioner in Albuquerque, NM