Individual provider Active NPI

Jennifer Duffy, FNP

  • Family Nurse Practitioner
  • Albuquerque, NM
National Provider Identifier
1013687011
Registry record updated May 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
65248 Issued in NM
Practice address
3825 Eubank Blvd NE Ste a
Albuquerque, NM 87111-3590
Phone
(505) 292-8575
Fax
(505) 292-8409
NPI assigned
Sep 20, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 19, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 65248 NM Primary

Addresses

Primary practice location

3825 Eubank Blvd NE Ste a
Albuquerque, NM 87111-3590

Mailing address

3825 Eubank Blvd NE Ste a
Albuquerque, NM 87111-3590
Phone (505) 292-8575

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20220426000493 NM Practitioner - Nurse Practitioner 6800283680 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Family Medicine PCGroup PAC ID 0042407603, 10 clinicians

Practice addresses (Care Compare)

3825 Eubank Blvd NE
Suite a
Albuquerque, NM 87111-3559
Phone (505) 292-8575

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Spencer J Hardenbrook MD PC CurrentSince May 11, 2023 Accepting new patients
Family Medicine PC CurrentSince Mar 1, 2022 Accepting new patients

Locations

3825 Eubank Blvd NE
Ste A
Albuquerque, NM 87111
Phone (505) 292-8575

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1632096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652918400000",
    "number": "1013687011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3825 EUBANK BLVD NE STE A",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871113590",
            "telephone_number": "505-292-8575",
            "fax_number": "505-292-8409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3825 EUBANK BLVD NE STE A",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871113590",
            "telephone_number": "505-292-8575",
            "fax_number": "505-292-8409"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUFFY",
        "first_name": "JENNIFER",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-09-20",
        "last_updated": "2022-05-19",
        "certification_date": "2022-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NM",
            "license": "65248",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.