Tiffany Kayla Autry, DNP FNP MEP-C

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

54435 Issued in NM

Practice address

1005 S Telshor Blvd Ste a
Las Cruces, NM 88011-4879

Phone

(575) 262-7546

Fax

(575) 888-2273

NPI assigned

Jan 4, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NM

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 1

Specialty

Nurse Practitioner

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles (1 of 7)

Locations

Networks

• NM HMO C-SNP
• devoted network organization-a4751131-f16f-4e82-8f2b-b08e66379a7a
• TX HMO D-SNP
• TX HMO
• CO HMO
• CO HMO D-SNP

Interoperability endpoints

• Direct secure messaging: tautry@elitederm.emadirect.md

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.

• Elite Aesthetics

  • Dermatology Physician
  • Las Cruces, NM
  • NPI 1902452360

  Single Specialty

  Medicare reassignment NPD

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

{
    "created_epoch": "1546560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735516800000",
    "number": "1003389875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 871",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880040871",
            "telephone_number": "409-719-8846",
            "fax_number": "575-888-2273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1005 S TELSHOR BLVD STE A",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880114879",
            "telephone_number": "575-262-7546",
            "fax_number": "575-888-2273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AUTRY",
        "first_name": "TIFFANY",
        "middle_name": "KAYLA",
        "name_prefix": "Dr.",
        "credential": "DNP FNP MEP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-01-04",
        "last_updated": "2024-12-30",
        "certification_date": "2024-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "NM",
            "license": "54435",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "31106285",
            "state": "NM"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tautry@elitederm.emadirect.md",
            "affiliation": "N",
            "address_1": "1005 S Telshor Blvd Ste A",
            "city": "Las Cruces",
            "state": "NM",
            "country_code": "US",
            "postal_code": "880114879",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Francis K. Attiogbe, M.D.
• Michelle Au
• Kathleen Jo Austin, CNP
• Catherine Marie Austrin
• Autism Diagnostic Center
• Auxion Care Concierge
• Abraham Avalos
• Arianna Ashley Avalos, RN
• Jacob Lee Avalos, CASE MANAGER
• Miguel Angel Avalos, A.B.O.C.

• Dermatology Physician in Las Cruces, NM
• Providers in Las Cruces, NM by specialty
• Dermatology Physician in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.