Individual provider Active NPI

Jacqueline L Cromeans, CNP

  • Nurse Practitioner
  • Albuquerque, NM
National Provider Identifier
1336233121
Registry record updated Jan 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
CNP01224 Issued in NM
Practice address
715 Dr Martin Luther King Jr Ave NE
Albuquerque, NM 87102-3661
Phone
(505) 727-3040
Fax
(505) 727-3099
NPI assigned
Oct 3, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X R49381 NM
Nurse Practitioner 363L00000X CNP01224 NM Primary

Addresses

Primary practice location

715 Dr Martin Luther King Jr Ave NE
Albuquerque, NM 87102-3661

Mailing address

715 Dr Martin Luther King Jr Ave NE
Suite 102
Albuquerque, NM 87102-3661
Phone (505) 727-3040

Other identifiers 1

IdentifierTypeStateIssuer
30838827MedicaidNM

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
I20040602000773 NM Practitioner - Nurse Practitioner 8921080128 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2003
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)

5901 Harper Dr NE
Albuquerque, NM 87109-3587
Phone (505) 823-8888

Hospital & facility affiliations

  • Presbyterian Hospital Hospital, Albuquerque, NM, CCN 320021

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
R49381NMMDEmergency Medicine Physician
CNP01224NMMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Presbyterian Healthcare Services Emergency Medicine CurrentSince Nov 1, 2015 Accepting new patients
Presbyterian Healthcare Services CurrentSince Nov 1, 2015 Accepting new patients
Presbyterian Healthcare Services Emergency Medicine Past Accepting new patients

Locations

5901 Harper Dr NE
Albuquerque, NM 87109
Phone (505) 823-8233

3630 Las Estancias Dr SW
Albuquerque, NM 87121
Phone (505) 462-7777

4588 Paradise Blvd NW
Albuquerque, NM 87114
Phone (505) 923-2070

6400 Paseo del Norte NE
Albuquerque, NM 87113
Phone (505) 596-2100

3436 Isleta Blvd SW
Albuquerque, NM 87105
Phone (505) 462-7777

4515 Coors Blvd NW
Albuquerque, NM 87120
Phone (505) 596-2200

8300 Constitution Ave NE
Bldg D
Albuquerque, NM 87110
Phone (505) 291-2200

3901 Atrisco Dr NW
Albuquerque, NM 87120
Phone (505) 462-7575

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

609 Christopher Dr
Belen, NM 87002
Phone (505) 861-1771

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

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

454 Saint Michaels Dr
Santa Fe, NM 87505
Phone (505) 303-5000

4801 Beckner Rd
Santa Fe, NM 87507
Phone (505) 772-1234

Interoperability endpoints

  • Direct secure messaging: jcromeans30311@direct.phs.org

Organizations & group practices 3

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.

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": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421107200000",
    "number": "1336233121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "715 DR MARTIN LUTHER KING JR AVE NE",
            "address_2": "SUITE 102",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871023661",
            "telephone_number": "505-727-3040",
            "fax_number": "505-727-3099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "715 DR MARTIN LUTHER KING JR AVE NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871023661",
            "telephone_number": "505-727-3040",
            "fax_number": "505-727-3099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROMEANS",
        "first_name": "JACQUELINE",
        "middle_name": "L",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-03",
        "last_updated": "2015-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NM",
            "license": "R49381",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NM",
            "license": "CNP01224",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30838827",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.