Individual provider Active NPI

Kristina Rynes, PH.D.

  • Prescribing (Medical) Psychologist
  • Albuquerque, NM
National Provider Identifier
1164848289
Registry record updated Aug 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prescribing (Medical) PsychologistTaxonomy code 103TP0016X
License
PSY-2022-0131 Issued in NM
Practice address
9301 Indian School Rd NE
Albuquerque, NM 87112-2884
Phone
(505) 218-6383
Fax
(505) 636-6338
NPI assigned
Mar 13, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 1, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 1252 NM
Prescribing (Medical) Psychologist 103TP0016X PSY-2022-0131 NM Primary

Addresses

Primary practice location

9301 Indian School Rd NE
Albuquerque, NM 87112-2884

Mailing address

8810 Vidal Rd SW
Albuquerque, NM 87105-7826
Phone (505) 307-5968

Other practice location 1

122 Tulane Dr SE Ste 4
Albuquerque, NM 87106-1468
Phone (505) 750-8462

Other identifiers 1

IdentifierTypeStateIssuer
25531026MedicaidNM

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
I20140828002128 NM Practitioner - Clinical Psychologist 1850519182 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3500 Comanche Rd NE
Suite 21
Albuquerque, NM 87107-4546
Phone (505) 750-8462

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PSY-2022-0131NMMDPrescribing (Medical) Psychologist

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.

NPI Registry JSON

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

{
    "created_epoch": "1394668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690848000000",
    "number": "1164848289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8810 VIDAL RD SW",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871057826",
            "telephone_number": "505-307-5968"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9301 INDIAN SCHOOL RD NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871122884",
            "telephone_number": "505-218-6383",
            "fax_number": "505-636-6338"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "122 Tulane Dr SE Ste 4",
            "address_purpose": "LOCATION",
            "city": "Albuquerque",
            "state": "NM",
            "postal_code": "871061468",
            "country_code": "US",
            "telephone_number": "505-750-8462",
            "fax_number": "505-349-5013",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RYNES",
        "first_name": "KRISTINA",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-03-13",
        "last_updated": "2023-08-01",
        "certification_date": "2023-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NM",
            "license": "1252",
            "primary": false
        },
        {
            "code": "103TP0016X",
            "taxonomy_group": "",
            "desc": "Psychologist, Prescribing (Medical)",
            "state": "NM",
            "license": "PSY-2022-0131",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "25531026",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.