Ryan Sturges Bozzell

Individual provider Active NPI Nurse Practitioner · Farmington, NM

NPI 1447722657 · NPPES record last updated Nov 14, 2024

Key facts

NPI
1447722657
Entity type
Individual (NPI type 1)
Primary specialty
Nurse Practitioner 363L00000X
License
54843 (NM)
Practice address
735 W Animas St
Farmington, NM 87401-5616
Phone
(505) 609-6300
NPI assigned
Dec 28, 2018
Sex
Male
Sole proprietor
No

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.

Medicare Care Compare profile

Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
San Juan Regional Medical Center, Inc. (233 clinicians)

Practice addresses (Care Compare)

801 W Maple St
Sjrmc ER Physicians
Farmington, NM 87401-5630
Phone (505) 609-2000

Merit-based Incentive Payment System (MIPS)

Final score
90.97 of 100 (group)
Quality
79.73
Promoting interoperability
100
Improvement activities
40
Cost
78.87

Medicare participation

Medicare fee-for-service enrollment
Enrolled in NM
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20190515001156 NM Practitioner - Nurse Practitioner 1355684382 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
54843NMMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
San Juan Regional Medical Center Inc Current
since Mar 10, 2019
Accepting new patients
San Juan Regional Medical Center Inc Current Accepting new patients
San Juan Regional Medical Center Inc Current
since Mar 10, 2019
Accepting new patients
San Juan Regional Medical Center Inc Current Accepting new patients

Locations

801 W Maple St
Farmington, NM 87401
Phone (505) 325-5011

735 W Animas St
Farmington, NM 87401
Phone (505) 564-6850

407 S Schwartz Ave
Ste 201
Farmington, NM 87401
Phone (505) 609-6300

4820 E Main St
Ste 2
Farmington, NM 87402
Phone (505) 609-6610

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 54843 NM Yes

Addresses

Primary practice location

735 W Animas St
Farmington, NM 87401-5616

Mailing address

PO Box 844088
Dallas, TX 75284-4088
Phone (505) 609-2258

Other providers in Farmington, NM

All providers in Farmington, NM · Nurse Practitioner in New Mexico

Sources for this page

Verify at the official NPI Registry.