Individual provider Active NPI

Patricia Lynn Bryant, M.D.

  • Internal Medicine Physician
  • Albuquerque, NM
National Provider Identifier
1114961786
Registry record updated Jul 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
86-185 Issued in NM
Practice address
9201 Montgomery Blvd NE Ste 301
Albuquerque, NM 87111-2467
Phone
(505) 717-1076
Fax
(866) 530-1835
NPI assigned
Jun 15, 2006
Last updated
Jul 12, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2024

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 86-185 NM
Internal Medicine Physician 207R00000X 86-185 NM Primary

Addresses

Primary practice location

9201 Montgomery Blvd NE Ste 301
Albuquerque, NM 87111-2467

Mailing address

4640 Jefferson LN NE
Suite B
Albuquerque, NM 87109-2116
Phone (505) 883-1259

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
I20040419001590 NM Practitioner - Internal Medicine 3577558469 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of New Mexico School of Medicine, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Elemental Health and Wellness Center LLCGroup PAC ID 0446481881, 12 clinicians
Southwest Gastroenterology AssociatesGroup PAC ID 2062316086, 27 clinicians

Practice addresses (Care Compare)

4425 Juan Tabo Blvd NE
Suite 112
Albuquerque, NM 87111-2684
Phone (505) 503-6800

7788 Jefferson St NE
Albuquerque, NM 87109-4342
Phone (505) 999-1600

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Elemental Health and Wellness Center LLC Family Medicine CurrentSince May 28, 2024 Accepting new patients
Southwest Gastroenterology Associates CurrentSince Feb 1, 2025 Accepting new patients
Optumcare New Mexico LLC Family Medicine Past Accepting new patients

Locations

4425 Juan Tabo Blvd NE
Ste 112
Albuquerque, NM 87111
Phone (505) 503-6800

7788 Jefferson St NE
Albuquerque, NM 87109
Phone (505) 999-1600

9201 Montgomery Blvd NE
Ste 301
Albuquerque, NM 87111
Phone (505) 717-1076

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/12517/brand/1/csg/1/fhir/r4
  • Direct secure messaging: patricia.lynn.bryant.1@12517.direct.athenahealth.com

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, 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": "1150329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720742400000",
    "number": "1114961786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4640 JEFFERSON LN NE",
            "address_2": "SUITE B",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871092116",
            "telephone_number": "505-883-1259",
            "fax_number": "505-883-3020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9201 MONTGOMERY BLVD NE STE 301",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871112467",
            "telephone_number": "505-717-1076",
            "fax_number": "866-530-1835"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRYANT",
        "first_name": "PATRICIA",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-15",
        "last_updated": "2024-07-12",
        "certification_date": "2024-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NM",
            "license": "86-185",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NM",
            "license": "86-185",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.