Individual provider Active NPI

Alfredo Quiralte, PA

  • Physician Assistant
  • Las Cruces, NM
National Provider Identifier
1285949297
Registry record updated May 19, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA2013-0016 Issued in NM
Practice address
1600 Thorpe Rd
Las Cruces, NM 88012-9776
Phone
(575) 382-9292
Fax
(575) 382-2061
NPI assigned
Aug 13, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PENDING FL
Physician Assistant 363A00000X PA2013-0016 NM Primary

Addresses

Primary practice location

1600 Thorpe Rd
Las Cruces, NM 88012-9776

Mailing address

PO Box 370
Hatch, NM 87937-0370
Phone (575) 267-3280

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
I20130916000136 NM Practitioner - Physician Assistant 5890939789 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PENDINGFLMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ben Archer Health Center CurrentSince Jun 11, 2013 Accepting new patients
Ben Archer Health Center CurrentSince Jun 11, 2013 Accepting new patients
Ben Archer Health Center Past Accepting new patients

Locations

2150 Highway 54 S
Alamogordo, NM 88310
Phone (575) 443-8133

1998 N Motel Blvd
Bldg A
Las Cruces, NM 88007

1998 N Motel Blvd
Las Cruces, NM 88007
Phone (575) 541-5941

1600 Thorpe Rd
Las Cruces, NM 88012
Phone (505) 267-3088

1960 N Date St
Truth Or Consequences, NM 87901
Phone (575) 894-7662

1950 N Date St
Truth Or Consequences, NM 87901
Phone (575) 894-8057

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1281657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1400457600000",
    "number": "1285949297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 370",
            "city": "HATCH",
            "state": "NM",
            "postal_code": "879370370",
            "telephone_number": "575-267-3280",
            "fax_number": "575-267-1747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 THORPE RD",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880129776",
            "telephone_number": "575-382-9292",
            "fax_number": "575-382-2061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUIRALTE",
        "first_name": "ALFREDO",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-08-13",
        "last_updated": "2014-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PENDING",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NM",
            "license": "PA2013-0016",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Cruces, NM

Sources for this page

Verify at the official NPI Registry.