Charmianne Cronk, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA2004-0031 Issued in NM

Practice address

3821 Masthead St NE
Albuquerque, NM 87109-4679

Phone

(505) 998-7400

Fax

(505) 998-7741

NPI assigned

May 13, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Physician Assistant

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

New Mexico Premier HealthGroup PAC ID 4385185354, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

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.

• New Mexico Premier Health

  • Primary Care Nurse Practitioner
  • Los Lunas, NM
  • NPI 1346071586
  Medicare reassignment Care Compare group
• Kewa Pueblo Health Corporation

  • Community/Behavioral Health Agency
  • Santo Domingo Pueblo, NM
  • NPI 1336659077
  NPD (past)
• New Mexico Premier Health

  • Urgent Care Clinic/Center
  • Los Lunas, NM
  • NPI 1760379325
  NPD (past)

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

{
    "created_epoch": "1147478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598659200000",
    "number": "1174574347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3821 MASTHEAD ST NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871094679",
            "telephone_number": "505-998-7400",
            "fax_number": "505-998-7741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3821 MASTHEAD ST NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871094679",
            "telephone_number": "505-998-7400",
            "fax_number": "505-998-7741"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRONK",
        "first_name": "CHARMIANNE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-13",
        "last_updated": "2020-08-29",
        "certification_date": "2020-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NM",
            "license": "PA2004-0031",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "12075272",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nancy Croker, MD
• Cody Jackson Crollett
• Jacqueline L Cromeans, CNP
• Brian Cronic
• Richard Cronin, MD
• Roger Leroy Cronk, DO
• Donnette Lynn Crook, PTA
• Keigm L Crook, D.D.S.
• Crooked Crane Healing
• Lida Ann Crooks, M.D.

• Physician Assistant in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Physician Assistant in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2020; 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.

Verify at the official NPI Registry.