Mr Ethan Blackney-lopez, AG-ACNP in Albuquerque, NM

Mr Ethan Blackney-lopez, AG-ACNP is a medicare enrolled "Nurse Practitioner - Acute Care" in Albuquerque, New Mexico. His current practice location is 2211 Lomas Blvd Ne, Albuquerque, New Mexico. You can reach out to his office (for appointments etc.) via phone at (505) 272-2711.

Mr Ethan Blackney-lopez is licensed to practice in New Mexico (license number 69604) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1619697570.

Contact Information

	Mr Ethan Blackney-lopez, AG-ACNP
	2211 Lomas Blvd Ne, Albuquerque, NM 87106-2719
	(505) 272-2711
	Not Available

Map and Direction

Provider's Profile

Full Name	Mr Ethan Blackney-lopez
Gender	Male
Speciality	Nurse Practitioner - Acute Care
Location	2211 Lomas Blvd Ne, Albuquerque, New Mexico
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1619697570
Provider Enumeration Date: 08/31/2022
Last Update Date: 05/26/2023

Medicare PECOS Information:

PECOS PAC ID: 6901273531
Enrollment ID: I20221110000814

Medical Identifiers

Medical identifiers for Mr Ethan Blackney-lopez such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1619697570	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LA2100X	Nurse Practitioner - Acute Care	69604 (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. Mr Ethan Blackney-lopez allows following entities to bill medicare on his behalf.

Entity Name	Unm Hospital
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1689747552 PECOS PAC ID: 7618889528 Enrollment ID: O20040110000011

Entity Name	Robben R Gingery Md Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1033527015 PECOS PAC ID: 0042514242 Enrollment ID: O20160209001273

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. Mr Ethan Blackney-lopez 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
Mr Ethan Blackney-lopez, AG-ACNP 9 Sena Dr, Los Lunas, NM 87031-6948 Ph: (505) 507-3987	Mr Ethan Blackney-lopez, AG-ACNP 2211 Lomas Blvd Ne, Albuquerque, NM 87106-2719 Ph: (505) 272-2711

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

Mr Ethan Blackney-lopez, AG-ACNP - Medicare Nurse Practitioner in Albuquerque, NM