Individual provider Active NPI

Elena Aurora Tyson, PH.D.

  • Psychologist
  • Rio Rancho, NM
National Provider Identifier
1124649090
Registry record updated Oct 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PSY-2023-0024 Issued in NM
Practice address
2600 College Ave NE
Rio Rancho, NM 87144-2103
Phone
(505) 994-5050
NPI assigned
May 2, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Group Psychotherapy Psychologist 103TP2701X PSY-2023-0024 NM
Psychologist 103T00000X PSY-2023-0024 NM Primary
Clinical Psychologist 103TC0700X PSY-2023-0024 NM
Clinical Child & Adolescent Psychologist 103TC2200X PSY-2023-0024 NM

Addresses

Primary practice location

2600 College Ave NE
Rio Rancho, NM 87144-2103

Mailing address

800 Bradbury Dr SE Ste 116
Albuquerque, NM 87106-4310
Phone (505) 272-1476

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address UNMMG@direct.health.unm.edu

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231108001244 NM Practitioner - Clinical Psychologist 0941657241 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Unm Medical Group IncGroup PAC ID 4981795267, 1,052 clinicians

Practice addresses (Care Compare)

2211 Lomas Blvd NE
Albuquerque, NM 87106-2719
Phone (505) 272-2111

Merit-based Incentive Payment System (MIPS)

Final score
89.64 of 100Reported as group
Quality
75.49
Promoting interoperability
100
Improvement activities
40
Cost
76.92

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PSY-2023-0024NMMDClinical Child & Adolescent Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Unm Medical Group Inc CurrentSince Sep 30, 2023 Accepting new patients
Unm Medical Group, Inc. CurrentSince Sep 30, 2023 Accepting new patients
Unm Medical Group Inc PastSince Apr 9, 2023 Accepting new patients

Locations

800 Bradbury Dr SE
Ste 116
Albuquerque, NM 87106
Phone (505) 272-1476

933 Bradbury Dr SE
Ste 2222
Albuquerque, NM 87106
Phone (505) 272-1476

2600 College Ave NE
Rio Rancho, NM 87144
Phone (505) 930-4499

2211 Lomas Blvd NE
Unm, NM 87106
Phone (505) 272-1111

Organizations & group practices 3

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": "1588377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730160000000",
    "number": "1124649090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 BRADBURY DR SE STE 116",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871064310",
            "telephone_number": "505-272-1476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 COLLEGE AVE NE",
            "city": "RIO RANCHO",
            "state": "NM",
            "postal_code": "871442103",
            "telephone_number": "505-994-5050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TYSON",
        "first_name": "ELENA",
        "middle_name": "AURORA",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-02",
        "last_updated": "2024-10-29",
        "certification_date": "2024-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TP2701X",
            "taxonomy_group": "",
            "desc": "Psychologist, Group Psychotherapy",
            "state": "NM",
            "license": "PSY-2023-0024",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NM",
            "license": "PSY-2023-0024",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NM",
            "license": "PSY-2023-0024",
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "NM",
            "license": "PSY-2023-0024",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "UNMMG@direct.health.unm.edu",
            "affiliation": "N",
            "address_1": "800 Bradbury Dr SE Ste 116",
            "city": "Albuquerque",
            "state": "NM",
            "country_code": "US",
            "postal_code": "871064310",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Rio Rancho, NM

Sources for this page

Verify at the official NPI Registry.