Individual provider Active NPI

Denise N Smallwood

  • Physician Assistant
  • Albuquerque, NM
National Provider Identifier
1174256226
Registry record updated Dec 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
10127 Avenida Vista Sol NW
Albuquerque, NM 87114-5903
Phone
(505) 803-7246
NPI assigned
Jul 6, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NM Primary

Addresses

Primary practice location

10127 Avenida Vista Sol NW
Albuquerque, NM 87114-5903

Mailing address

10127 Avenida Vista Sol NW
Albuquerque, NM 87114-5903

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
I20240124003752 NM Practitioner - Physician Assistant 0143673327 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Presbyterian Healthcare ServicesGroup PAC ID 9234041708, 1,390 clinicians

Practice addresses (Care Compare)

2200 W 21St St
Clovis, NM 88101-2011
Phone (505) 769-7577

2400 Unser Blvd SE
Rio Rancho, NM 87124-3392

2400 Unser Blvd SE
Rio Rancho, NM 87124-4740

8300 Constitution Ave NE
Albuquerque, NM 87110-7613

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Presbyterian Healthcare Services CurrentSince Jan 29, 2024 Accepting new patients
Presbyterian Healthcare Services CurrentSince Jan 29, 2024 Accepting new patients
Presbyterian Healthcare Services Past Accepting new patients

Locations

2200 W 21st St
Clovis, NM 88101
Phone (505) 769-7577

2400 Unser Blvd SE
Ste 29100
Rio Rancho, NM 87124
Phone (505) 559-6220

Interoperability endpoints

  • Direct secure messaging: dsmallwood244180@direct.phs.org

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.

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": "1657065600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701907200000",
    "number": "1174256226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10127 AVENIDA VISTA SOL NW",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871145903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10127 AVENIDA VISTA SOL NW",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871145903",
            "telephone_number": "505-803-7246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMALLWOOD",
        "first_name": "DENISE",
        "middle_name": "N",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-07-06",
        "last_updated": "2023-12-07",
        "certification_date": "2023-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NM",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.