NPIMap

Individual provider Active NPI

Cloyce Elizabeth Blakely, PA-C

  • Physician Assistant
  • Albuquerque, NM
National Provider Identifier
1184087744
Registry record updated May 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA2016-0015 Issued in NM
Practice address
201 Cedar St SE Ste 5660
Albuquerque, NM 87106-4920
Phone
(505) 563-6565
NPI assigned
Mar 31, 2016
Last updated
May 13, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA175856 OR
Physician Assistant 363A00000X PA2016-0015 NM Primary
Surgical Physician Assistant 363AS0400X PA175856 OR

Addresses

Primary practice location

201 Cedar St SE Ste 5660
Albuquerque, NM 87106-4920

Mailing address

3723 SE 40TH Ave
Portland, OR 97202-1710
Phone (505) 818-3818

Other names 1

  • Cloyce Elizabeth Nelson Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190718001403 NM Practitioner - Physician Assistant 0042500134 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Presbyterian Healthcare ServicesGroup PAC ID 9234041708, 1,390 clinicians

Practice addresses (Care Compare)

1100 Central Ave SE
Albuquerque, NM 87106-4930
Phone (505) 841-1234

201 Cedar St SE
Albuquerque, NM 87106-4917

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

2400 Unser Blvd SE
Rio Rancho, NM 87124-4740

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.68 of 100Reported as group
Quality
82.35
Promoting interoperability
100
Improvement activities
40
Cost
76.6

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Presbyterian Healthcare Services CurrentSince Aug 12, 2019 Accepting new patients
Presbyterian Healthcare Services CurrentSince Aug 12, 2019 Accepting new patients
Presbyterian Healthcare Services Past Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

201 Cedar St SE
Ste 5660
Albuquerque, NM 87106
Phone (505) 563-6565

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

Interoperability endpoints

  • Direct secure messaging: cblakely143707@direct.phs.org

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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": "1459382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557705600000",
    "number": "1184087744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3723 SE 40TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972021710",
            "telephone_number": "505-818-3818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 CEDAR ST SE STE 5660",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871064920",
            "telephone_number": "505-563-6565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAKELY",
        "first_name": "CLOYCE",
        "middle_name": "ELIZABETH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-31",
        "last_updated": "2019-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "PA175856",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NM",
            "license": "PA2016-0015",
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "OR",
            "license": "PA175856",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CLOYCE",
            "last_name": "NELSON",
            "middle_name": "ELIZABETH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.