Individual provider Active NPI

Antonio Briceno Parra, NP

  • Family Nurse Practitioner
  • Albuquerque, NM
National Provider Identifier
1306681275
Registry record updated Jul 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
55814 Issued in NM
Practice address
8417 Washington PL NE Ste a
Albuquerque, NM 87113-1720
Phone
(505) 273-9453
Fax
(505) 503-1619
NPI assigned
Jul 1, 2024
Last updated
Jul 4, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 4, 2024

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 55814 NM Primary

Addresses

Primary practice location

8417 Washington PL NE Ste a
Albuquerque, NM 87113-1720

Mailing address

11447 Manzano Vista Ave SE
Albuquerque, NM 87123-2975
Phone (407) 990-3828

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
I20241009000977 NM Practitioner - Nurse Practitioner 7911438346 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Total Balance Healthcare, LLCGroup PAC ID 7911394457, 3 clinicians

Practice addresses (Care Compare)

8417 Washington PL NE
Suite a
Albuquerque, NM 87113-1720
Phone (505) 273-9453

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Total Balance Healthcare, LLC Family CurrentSince Jul 1, 2024 Accepting new patients
Albuquerque Amg Specialty Hospital, LLC CurrentSince Jul 1, 2024 Accepting new patients
Revitalized Natural Health Center PastSince Jul 1, 2024 Accepting new patients

Locations

101 La Rue France
Ste 500
Lafayette, LA 70508
Phone (337) 269-9566

5400 Gibson Blvd SE
Ste 2
Albuquerque, NM 87108
Phone (505) 262-7174

5400 Gibson Blvd SE
Ste 3
Albuquerque, NM 87108
Phone (505) 842-5550

8417 Washington Pl NE
Ste A
Albuquerque, NM 87113
Phone (505) 273-9453

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/10671/brand/1/csg/1/fhir/r4

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 1

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": "1719792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720051200000",
    "number": "1306681275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11447 MANZANO VISTA AVE SE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871232975",
            "telephone_number": "407-990-3828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8417 WASHINGTON PL NE STE A",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871131720",
            "telephone_number": "505-273-9453",
            "fax_number": "505-503-1619"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRICENO PARRA",
        "first_name": "ANTONIO",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-07-01",
        "last_updated": "2024-07-04",
        "certification_date": "2024-07-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NM",
            "license": "55814",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.