Individual provider Active NPI

John Edward Panter, PA

  • Physician Assistant
  • Albuquerque, NM
National Provider Identifier
1407294655
Registry record updated Apr 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
11501 Montgomery Blvd NE
Albuquerque, NM 87111-2796
Phone
(505) 814-1333
Fax
(505) 990-3437
NPI assigned
Jun 10, 2013
Last updated
Apr 6, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

11501 Montgomery Blvd NE
Albuquerque, NM 87111-2796

Mailing address

12127B Hwy 14 N Ste 5
Cedar Crest, NM 87008-9557
Phone (505) 281-5180

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
I20130905000635 NM Practitioner - Physician Assistant 9537302898 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
McLeod Medical Centers of NM IncGroup PAC ID 5092075531, 54 clinicians

Practice addresses (Care Compare)

1108 US Route 66 W
Moriarty, NM 87035-1006
Phone (505) 281-5180

11501 Montgomery Blvd NE
Albuquerque, NM 87111-2796
Phone (505) 281-5180

12127B Hwy 14 N
Suite 5
Cedar Crest, NM 87008-9499
Phone (505) 281-5180

1901 Juan Tabo Blvd NE
Albuquerque, NM 87112-3303
Phone (505) 281-5180

7200 Montgomery Blvd NE
Suite 7121
Albuquerque, NM 87109-1510
Phone (505) 281-5180

National Provider Directory

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

Interoperability endpoints

  • Direct secure messaging: john.panter.1@27050.direct.athenahealth.com

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1370822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617667200000",
    "number": "1407294655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12127B HWY 14 N STE 5",
            "city": "CEDAR CREST",
            "state": "NM",
            "postal_code": "870089557",
            "telephone_number": "505-281-5180",
            "fax_number": "505-281-5320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11501 MONTGOMERY BLVD NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871112796",
            "telephone_number": "505-814-1333",
            "fax_number": "505-990-3437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANTER",
        "first_name": "JOHN",
        "middle_name": "EDWARD",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-10",
        "last_updated": "2021-04-06",
        "certification_date": "2021-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.