Individual provider Active NPI

Lizette Alejandra Sidransky-Ulloa, CNP

  • Nurse Practitioner
  • Albuquerque, NM
National Provider Identifier
1023682580
Registry record updated Aug 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
63716 Issued in NM
Practice address
5901 Harper Drive NE
Albuquerque, NM 87109-3589
Phone
(505) 823-8870
NPI assigned
May 18, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 63716 NM
Nurse Practitioner 363L00000X 63716 NM Primary

Addresses

Primary practice location

5901 Harper Drive NE
Albuquerque, NM 87109-3589

Mailing address

5901 Harper Drive NE
Albuquerque, NM 87109-3589
Phone (505) 823-8870

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
I20210727002884 NM Practitioner - Nurse Practitioner 3678976768 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Presbyterian Healthcare ServicesGroup PAC ID 9234041708, 1,390 clinicians

Practice addresses (Care Compare)

5901 Harper Dr NE
Albuquerque, NM 87109-3587
Phone (505) 823-8888

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.68 of 100Reported as group
Quality
82.35
Promoting interoperability
100
Improvement activities
40
Cost
76.6

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Presbyterian Healthcare Services Family Medicine Current Accepting new patients
Presbyterian Healthcare Services CurrentSince May 2, 2022 Accepting new patients
Alignmed Partners, PC CurrentSince Jun 22, 2021 Accepting new patients
Presbyterian Healthcare Services Past Accepting new patients

Locations

5901 Harper Dr NE
Albuquerque, NM 87109
Phone (505) 823-8233

5123 Juan Tabo Blvd NE
Albuquerque, NM 87111
Phone (505) 292-3333

8300 Constitution Ave NE
Bldg D
Albuquerque, NM 87110
Phone (505) 291-2200

1831 Camino del Llano
Belen, NM 87002
Phone (505) 864-1600

Interoperability endpoints

  • Direct secure messaging: lsidranskyulloa211096@direct.phs.org

Organizations & group practices 4

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1621296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692662400000",
    "number": "1023682580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5901 HARPER DRIVE NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871093589",
            "telephone_number": "505-823-8870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5901 HARPER DRIVE NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871093589",
            "telephone_number": "505-823-8870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIDRANSKY-ULLOA",
        "first_name": "LIZETTE",
        "middle_name": "ALEJANDRA",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-18",
        "last_updated": "2023-08-22",
        "certification_date": "2021-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NM",
            "license": "63716",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NM",
            "license": "63716",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.