Active NPI
Kristina Rynes, PH.D.
- Prescribing (Medical) Psychologist
- Albuquerque, NM
National Provider Identifier
1164848289
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prescribing (Medical) Psychologist
- License
- PSY-2022-0131
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 25531026 | Medicaid | NM |
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
Enrollment records 1
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
| License | State | Type | Specialty |
|---|---|---|---|
| PSY-2022-0131 | NM | MD | Prescribing (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.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Albuquerque, NM
- NPI 1710543475
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.