Individual provider Active NPI

Alexandra Quane Cotter, PA-C

  • Physician Assistant
  • Gallup, NM
National Provider Identifier
1093190969
Registry record updated Feb 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA2022-0102 Issued in NM
Practice address
2022 E Aztec Ave
Gallup, NM 87301-4804
Phone
(505) 397-5172
Fax
(877) 396-1184
NPI assigned
Jul 21, 2015
Last updated
Feb 16, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0010-05917 NC
Physician Assistant 363A00000X PA2022-0102 NM Primary

Addresses

Primary practice location

2022 E Aztec Ave
Gallup, NM 87301-4804

Mailing address

2022 E Aztec Ave
Gallup, NM 87301-4804
Phone (505) 397-5172

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, NM2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20161230000297 NC Practitioner - Physician Assistant 5395026579 Reassigns benefits to 1 organization
I20230331001698 NM Practitioner - Physician Assistant 5395026579 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
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)

1100 Central Ave SE
Albuquerque, NM 87106-4930
Phone (505) 841-1234

201 Cedar St SE
Suite 7600
Albuquerque, NM 87106-4921
Phone (505) 563-2500

2200 W 21St St
Clovis, NM 88101-2011
Phone (505) 769-7577

2400 Unser Blvd SE
Rio Rancho, NM 87124-4740

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Presbyterian Healthcare Services CurrentSince Oct 9, 2023 Accepting new patients
Presbyterian Healthcare Services CurrentSince Oct 9, 2023 Accepting new patients
Duke University Health System, Inc. CurrentSince Dec 7, 2020 Accepting new patients
Duke University Health System, Inc. CurrentSince Dec 7, 2020 Accepting new patients
GCH Campus Clinic Current Accepting new patients
Presbyterian Healthcare Services Past Accepting new patients

Locations

2100 Erwin Rd
Durham, NC 27705
Phone (919) 648-8111

2301 Erwin Rd
Durham, NC 27705
Phone (919) 668-0289

5213 S Alston Ave
Durham, NC 27713
Phone (919) 620-4700

1100 Central Ave SE
Albuquerque, NM 87106
Phone (505) 724-6124

201 Cedar St SE
Ste 7600
Albuquerque, NM 87106
Phone (505) 563-2500

201 Cedar St SE
Ste 800
Albuquerque, NM 87106
Phone (505) 563-2500

8300 Constitution Ave NE
Albuquerque, NM 87110
Phone (505) 291-2000

2200 W 21st St
Clovis, NM 88101
Phone (505) 769-7577

2111 College Dr
Gallup, NM 87301
Phone (505) 397-5172

2400 Unser Blvd SE
Rio Rancho, NM 87124
Phone (505) 253-0000

Interoperability endpoints

  • Direct secure messaging: acotter239458@direct.phs.org
  • Direct secure messaging: acotter251153@direct.medicine.duke.edu

Organizations & group practices 8

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

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": "1437436800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676505600000",
    "number": "1093190969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2022 E AZTEC AVE",
            "city": "GALLUP",
            "state": "NM",
            "postal_code": "873014804",
            "telephone_number": "505-397-5172",
            "fax_number": "877-396-1184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2022 E AZTEC AVE",
            "city": "GALLUP",
            "state": "NM",
            "postal_code": "873014804",
            "telephone_number": "505-397-5172",
            "fax_number": "877-396-1184"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COTTER",
        "first_name": "ALEXANDRA",
        "middle_name": "QUANE",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-21",
        "last_updated": "2023-02-16",
        "certification_date": "2023-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-05917",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NM",
            "license": "PA2022-0102",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gallup, NM

Sources for this page

Verify at the official NPI Registry.