Elise Nicole Pedigo, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA2017-0099 Issued in NM

Practice address

630 Haines Ave NW
Albuquerque, NM 87102-1226

Phone

(505) 268-5611

Fax

(505) 268-5736

NPI assigned

Oct 12, 2017

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NM, WA, CO3 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 3

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/21373/brand/1/csg/1/fhir/r4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• James H. Rice, M.D.,PC

  • Pain Medicine (Anesthesiology) Physician
  • Albuquerque, NM
  • NPI 1932411220
  Medicare reassignment
• Pinnacle Pain Center, PS

  • Pain Medicine (Anesthesiology) Physician
  • Kennewick, WA
  • NPI 1740434356
  Medicare reassignment
• Metro Treatment of New Mexico LP

  • Methadone Clinic
  • Albuquerque, NM
  • NPI 1710512199
  NPD
• Metro Treatment of New Mexico LP

  • Methadone Clinic
  • Albuquerque, NM
  • NPI 1144437294
  NPD (past)
• Santa Fe Pain & Spine Specialists PC

  • Pain Medicine (Anesthesiology) Physician
  • Rio Rancho, NM
  • NPI 1700814316
  NPD (past)
• Kenneth C. Lewis MD,LLC

  • Pain Medicine (Anesthesiology) Physician
  • Grand Junction, CO
  • NPI 1912639642
  NPD (past)
• Tran Urgent Care & Wellness Centers LLC

  • Urgent Care Clinic/Center
  • Tacoma, WA
  • NPI 1003446857
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1507766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692144000000",
    "number": "1003327487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3864 MASTHEAD ST NE UNIT E2",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871094479",
            "telephone_number": "505-356-4178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "630 HAINES AVE NW",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871021226",
            "telephone_number": "505-268-5611",
            "fax_number": "505-268-5736"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEDIGO",
        "first_name": "ELISE",
        "middle_name": "NICOLE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-12",
        "last_updated": "2023-08-16",
        "certification_date": "2023-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NM",
            "license": "PA2017-0099",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pediatric Health Services PC
• Pediatric Speech Services of Albuquerque
• Pediatric Therapy Inc.
• Pediatrix Cardiology of New Mexico, P.C.
• Pediatrix Medical Group of New Mexico, P.C.
• Lilia Pedrego, MD
• Victoria M Pedroncelli
• Kurt Matthew Pedrotty, M.D.
• Mark Henry Pedrotty, PHD
• Yesenia Pedroza

• Physician Assistant in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Physician Assistant in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.