Individual provider Active NPI

Anna Marie Siow, PA

  • Physician Assistant
  • Albuquerque, NM
National Provider Identifier
1194170605
Registry record updated Jul 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA2016-0007 Issued in NM
Practice address
1014 Hummingbird PL SW
Albuquerque, NM 87105-8130
Phone
(505) 582-4246
NPI assigned
May 3, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2020

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 PA2016-0007 NM Primary

Addresses

Primary practice location

1014 Hummingbird PL SW
Albuquerque, NM 87105-8130

Mailing address

1014 Hummingbird PL SW
Albuquerque, NM 87105-8130
Phone (505) 582-4246

Other identifiers 2

IdentifierTypeStateIssuer
44670575MedicaidNM
PA2016-0007OtherNMPA LICENSE

Other names 1

  • Anna Marie Jaramillo Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM, TX2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20170720001612 NM Practitioner - Physician Assistant 8426328600 Reassigns benefits to 6 organizations
I20201229003074 TX Practitioner - Physician Assistant 8426328600 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
New Mexico Urgent Care Walk-in Clinic Juan Tabo LLCGroup PAC ID 6901283258, 8 clinicians
New Mexico Urgent Care Walk-in Clinic LLCGroup PAC ID 4486062940, 3 clinicians

Practice addresses (Care Compare)

10820 Comanche Rd NE
Suite a
Albuquerque, NM 87111-3983
Phone (505) 508-4068

3111 Eubank Blvd NE
Suite B
Albuquerque, NM 87111-4875
Phone (505) 433-2375

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA2016-0007NMMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Nativa Medical LLC Physician Assistant CurrentSince Jul 5, 2020 Accepting new patients

Organizations & group practices 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1462233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593648000000",
    "number": "1194170605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1014 HUMMINGBIRD PL SW",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871058130",
            "telephone_number": "505-582-4246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1014 HUMMINGBIRD PL SW",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871058130",
            "telephone_number": "505-582-4246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIOW",
        "first_name": "ANNA",
        "middle_name": "MARIE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-03",
        "last_updated": "2020-07-02",
        "certification_date": "2020-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NM",
            "license": "PA2016-0007",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "44670575",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PA LICENSE",
            "identifier": "PA2016-0007",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANNA",
            "last_name": "JARAMILLO",
            "middle_name": "MARIE",
            "credential": "PA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.