Individual provider Active NPI

Jennifer M Pas, R.D., L.D.

  • Registered Dietitian
  • Albuquerque, NM
National Provider Identifier
1356385751
Registry record updated Jun 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
362 Issued in NM
Practice address
4425 Juan Tabo Blvd NE
Albuquerque, NM 87111-2681
Phone
(505) 332-8070
NPI assigned
Jun 15, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 362 NM Primary

Addresses

Primary practice location

4425 Juan Tabo Blvd NE
Albuquerque, NM 87111-2681

Mailing address

4425 Juan Tabo Blvd NE
Albuquerque, NM 87111-2681
Phone (505) 332-8070

Other names 1

  • Jennifer M. Gilmore Former name

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20070127000098 NM Practitioner - Registered Dietitian Or Nutrition Professional 7911959275 Reassigns benefits to 2 organizations
I20210915001222 TX Practitioner - Registered Dietitian Or Nutrition Professional 7911959275 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
362NMMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
Rehoboth McKinley Christian Health Care Services, Inc. Current Accepting new patients
Canoncito Band of Navajos Health Center, Inc Current Accepting new patients
Rehoboth McKinley Christian Health Care Services, Inc CurrentSince May 22, 2025 Accepting new patients
Rehoboth McKinley Christian Health Care Services, Inc CurrentSince May 22, 2025 Accepting new patients
Canoncito Band of Navajos Health Center, Inc. CurrentSince Aug 10, 2021 Accepting new patients
Global Nutrition Services, LLC Dietitian, Registered Past Accepting new patients
Deming Hospital Corporation Past Accepting new patients

Locations

1901 Red Rock Dr
Gallup, NM 87301
Phone (505) 863-7000

129 Medicine Horse Dr
Tohajiilee, NM 87026
Phone (505) 908-2307

Organizations & group practices 7

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": "1150329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433808000000",
    "number": "1356385751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4425 JUAN TABO BLVD NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871112681",
            "telephone_number": "505-332-8070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4425 JUAN TABO BLVD NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871112681",
            "telephone_number": "505-332-8070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAS",
        "first_name": "JENNIFER",
        "middle_name": "M",
        "credential": "R.D., L.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-15",
        "last_updated": "2015-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NM",
            "license": "362",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "GILMORE",
            "middle_name": "M.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Albuquerque, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.