Martin Nicholas Ancona, PHD, MP
Individual provider Active NPI Prescribing (Medical) Psychologist · Anthony, NM
NPI 1003065749 · NPPES record last updated Sep 8, 2026
Key facts
- NPI
- 1003065749
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Prescribing (Medical) Psychologist 103TP0016X
- License
- 0040C (NM)
- Practice address
- 224 Anthony Dr Ste B
Anthony, NM 88021-9190 - Phone
- (575) 489-8999
- Fax
- (575) 205-0068
- NPI assigned
- Sep 18, 2008
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 3
Medicare Care Compare profile
- Specialty
- Clinical Psychologist
- Education
- Other, 2013
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
224 Anthony Dr
Anthony, NM 88021-9366
Phone (214) 662-1791
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NM
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20140214000421 | NM | Practitioner - Clinical Psychologist | 4789813700 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PY60201752 | WA | MD | Psychologist |
| 0040C | NM | MD | Prescribing (Medical) Psychologist |
| 1296 | NM | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Martin Ancona LLC | Clinical | Current |
Accepting new patients |
| Amanecer Community Counseling Center, LLC | Past |
Accepting new patients | |
| Adl Counseling LLC | Past |
Accepting new patients |
Locations
224 Anthony Dr
Ste B
Anthony, NM 88021
Phone (575) 489-8999
224 Anthony Dr
Anthony, NM 88021
Phone (214) 662-1791
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Prescribing (Medical) Psychologist | 103TP0016X | 0040C | NM | Yes |
| Clinical Psychologist | 103TC0700X | 1296 | NM | |
| Psychologist | 103T00000X | PY60201752 | WA |
Addresses
Primary practice location
224 Anthony Dr Ste B
Anthony, NM 88021-9190
Mailing address
224 Anthony Dr Ste B
Anthony, NM 88021-9190
Phone (575) 489-8999
Other providers in Anthony, NM
- Mayra Alvarez-Bernal
- Yvette Alvidrez
- Amanecer Community Counseling Center, LLC
- Angela Anaya
- Marco Mitchell Anchondo
- Ruben Anguiano
- Melissa Arciero-Durr
- Erika Armendariz
- Justice M Au
- Moatasem Azzam
All providers in Anthony, NM · Prescribing (Medical) Psychologist in New Mexico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 8, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.