Individual provider Active NPI

Vivienne Prinz, CNP

  • Family Nurse Practitioner
  • Edgewood, NM
National Provider Identifier
1194154823
Registry record updated Apr 30, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
CNP-02281 Issued in NM
Practice address
104 Quail TRL
Unit B
Edgewood, NM 87015-7185
Phone
(505) 208-0204
NPI assigned
Nov 4, 2013
Last updated
Apr 30, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X CNP-02281 NM Primary

Addresses

Primary practice location

104 Quail TRL
Unit B
Edgewood, NM 87015-7185

Mailing address

104 Quail TRL
Unit B
Edgewood, NM 87015-7185
Phone (505) 286-2396

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
I20131204001838 NM Practitioner - Nurse Practitioner 8527294107 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
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)

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

8300 Constitution Ave NE
Albuquerque, NM 87110-7613

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
Certified Nurse Practitioner, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
CNP-02281NMMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Presbyterian Healthcare Services CurrentSince May 1, 2022 Accepting new patients
Presbyterian Healthcare Services CurrentSince May 1, 2022 Accepting new patients
Presbyterian Healthcare Services Past Accepting new patients
Santa Fe Pain & Spine Specialists PC Past Accepting new patients

Locations

8300 Constitution Ave NE
Albuquerque, NM 87110
Phone (505) 291-2000

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

2400 Unser Blvd SE
Ste 9100B
Rio Rancho, NM 87124
Phone (505) 926-1400

4100 High Resort Blvd SE
Rio Rancho, NM 87124
Phone (505) 291-2770

4100 High Resort Blvd SE
Ste 215
Rio Rancho, NM 87124
Phone (505) 291-2770

Interoperability endpoints

  • Direct secure messaging: vprinz103905@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 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": "1383523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525046400000",
    "number": "1194154823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 QUAIL TRL",
            "address_2": "UNIT B",
            "city": "EDGEWOOD",
            "state": "NM",
            "postal_code": "870157185",
            "telephone_number": "505-286-2396",
            "fax_number": "505-286-2398"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 QUAIL TRL",
            "address_2": "UNIT B",
            "city": "EDGEWOOD",
            "state": "NM",
            "postal_code": "870157185",
            "telephone_number": "505-208-0204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRINZ",
        "first_name": "VIVIENNE",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-11-04",
        "last_updated": "2018-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NM",
            "license": "CNP-02281",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edgewood, NM

Sources for this page

Verify at the official NPI Registry.