Individual provider Active NPI

William T Yelverton, P.A.

  • Surgical Physician Assistant
  • Albuquerque, NM
National Provider Identifier
1164400479
Registry record updated Jul 16, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
2001-PA35 Issued in NM
Practice address
201 Cedar St SE
Suite 6600
Albuquerque, NM 87106-4917
Phone
(505) 724-4300
Fax
(505) 724-4384
NPI assigned
Jan 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2013

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 2001-PA35 NM
Surgical Physician Assistant 363AS0400X 2001-PA35 NM Primary

Addresses

Primary practice location

201 Cedar St SE
Suite 6600
Albuquerque, NM 87106-4917

Mailing address

201 Cedar St SE
Suite 6600
Albuquerque, NM 87106-4917
Phone (505) 724-4300

Other identifiers 1

IdentifierTypeStateIssuer
0000K1005MedicaidNM

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
I20101111001492 NM Practitioner - Physician Assistant 8123213402 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of New Mexico School of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2100 Louisiana Blvd NE
Suite 410
Albuquerque, NM 87110-5412
Phone 50572443003208

2101 Unser Blvd SE
Nmo Rio Rancho Clinic
Rio Rancho, NM 87124-6378
Phone (505) 724-4700

Hospital & facility affiliations

  • Presbyterian Hospital Hospital, Albuquerque, NM, CCN 320021

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2001-PA35NMMDSurgical Physician Assistant

Interoperability endpoints

  • Direct secure messaging: wyelverton11975@ahs.direct-ci.com

Organizations & group practices 1

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": "1136505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1373932800000",
    "number": "1164400479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 CEDAR ST SE",
            "address_2": "SUITE 6600",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871064917",
            "telephone_number": "505-724-4300",
            "fax_number": "505-724-4384"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 CEDAR ST SE",
            "address_2": "SUITE 6600",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871064917",
            "telephone_number": "505-724-4300",
            "fax_number": "505-724-4384"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YELVERTON",
        "first_name": "WILLIAM",
        "middle_name": "T",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-06",
        "last_updated": "2013-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NM",
            "license": "2001-PA35",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NM",
            "license": "2001-PA35",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0000K1005",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.