Individual provider Active NPI

Cynthia Amaya, CPNP-PC

  • Pediatrics Physician
  • Roswell, NM
National Provider Identifier
1104497148
Registry record updated Jul 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
APRN-CNP-64439 Issued in NM
Practice address
813 N Washington Ave
Roswell, NM 88201-3941
Phone
(575) 622-2606
NPI assigned
Jul 9, 2021
Last updated
Jul 9, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X APRN-CNP-64439 NM Primary

Addresses

Primary practice location

813 N Washington Ave
Roswell, NM 88201-3941

Mailing address

813 N Washington Ave
Roswell, NM 88201-3941
Phone (575) 622-2606

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210909002137 NM Practitioner - Pediatric Medicine 9931505377

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN-CNP-64439NMMDPediatrics Physician

NPI Registry JSON

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

{
    "created_epoch": "1625788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625788800000",
    "number": "1104497148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "813 N WASHINGTON AVE",
            "city": "ROSWELL",
            "state": "NM",
            "postal_code": "882013941",
            "telephone_number": "575-622-2606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "813 N WASHINGTON AVE",
            "city": "ROSWELL",
            "state": "NM",
            "postal_code": "882013941",
            "telephone_number": "575-622-2606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMAYA",
        "first_name": "CYNTHIA",
        "credential": "CPNP-PC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-09",
        "last_updated": "2021-07-09",
        "certification_date": "2021-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NM",
            "license": "APRN-CNP-64439",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roswell, NM

Sources for this page

Verify at the official NPI Registry.