Alissa Renee Hurtado, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA2021-0069 Issued in NM

Practice address

3436 Isleta Blvd SW
Albuquerque, NM 87105-5837

Phone

(505) 596-2300

NPI assigned

Jan 18, 2020

Last updated

Sep 9, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1579305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631145600000",
    "number": "1306476379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 26666",
            "address_2": "PROVIDER ENROLLMENT",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871256666",
            "telephone_number": "505-923-6770",
            "fax_number": "505-923-5354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3436 ISLETA BLVD SW",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871055837",
            "telephone_number": "505-596-2300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HURTADO",
        "first_name": "ALISSA",
        "middle_name": "RENEE",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-01-18",
        "last_updated": "2021-09-09",
        "certification_date": "2021-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NM",
            "license": "PA2021-0069",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Natalie J Hurst, MS, CCC-SLP
• Bryan Lance Hurt, PH.D.
• Hans Fredrick Hurt, M.D.
• Kenneth C Hurt, D.D.S., M.S.
• Vanessa Alexandra Hurtado Tandazo, M.D
• Gabriel Hurtado
• Gabrielle Hurtado
• Sara Hurtado, LISW
• Sajad Abid Husain
• Jeffrey W Huser, MD

• 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 Sep 9, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.