Individual provider Active NPI

Brenda Lee Fuselier, CNP-APRN

  • Nurse Practitioner
  • Portales, NM
National Provider Identifier
1447899463
Registry record updated Jul 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
60176 Issued in NM
Practice address
304 S Main Ave
Portales, NM 88130-6218
Phone
(575) 226-3023
Fax
(575) 226-3024
NPI assigned
Dec 23, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 60176 NM
Family Nurse Practitioner 363LF0000X R43905 NM
Nurse Practitioner 363L00000X 60176 NM Primary

Addresses

Primary practice location

304 S Main Ave
Portales, NM 88130-6218

Mailing address

PO Box 55
Portales, NM 88130-0055
Phone (575) 226-3023

Other practice location 1

530 S Roosevelt Road V
Portales, NM 88130-9121
Phone (575) 562-0435 ext. 57556

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
I20200910000739 NM Practitioner - Nurse Practitioner 2961820733 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Presbyterian Medical ServicesGroup PAC ID 2062324684, 132 clinicians

Practice addresses (Care Compare)

1422 Paseo de Peralta
Santa Fe, NM 87501-4391
Phone (505) 982-5565

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
60176NMMDNurse Practitioner
R43905NMMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Presbyterian Medical Services CurrentSince Oct 25, 2021 Accepting new patients
Sievers Sports Medicine Inc CurrentSince Jun 1, 2021 Accepting new patients
Presbyterian Medical Services Current Accepting new patients
Presbyterian Healthcare Services CurrentSince Sep 1, 2020 Accepting new patients
Presbyterian Medical Services CurrentSince Oct 25, 2021 Accepting new patients
Presbyterian Healthcare Services CurrentSince Sep 1, 2020 Accepting new patients

Locations

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

304 S Main Ave
Portales, NM 88130
Phone (575) 226-3023

1422 Paseo de Peralta
Santa Fe, NM 87501
Phone (505) 982-5565

Interoperability endpoints

  • Direct secure messaging: brenda.fuselier.p1@direct.pmsnm.nextgenshare.com

Organizations & group practices 6

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": "1577059200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625097600000",
    "number": "1447899463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 55",
            "city": "PORTALES",
            "state": "NM",
            "postal_code": "881300055",
            "telephone_number": "575-226-3023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "304 S MAIN AVE",
            "city": "PORTALES",
            "state": "NM",
            "postal_code": "881306218",
            "telephone_number": "575-226-3023",
            "fax_number": "575-226-3024"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "530 S Roosevelt Road V",
            "address_purpose": "LOCATION",
            "city": "Portales",
            "state": "NM",
            "postal_code": "881309121",
            "country_code": "US",
            "telephone_number": "575-562-0435 x57556",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FUSELIER",
        "first_name": "BRENDA",
        "middle_name": "LEE",
        "credential": "CNP-APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-23",
        "last_updated": "2021-07-01",
        "certification_date": "2021-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NM",
            "license": "60176",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NM",
            "license": "R43905",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NM",
            "license": "60176",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portales, NM

Sources for this page

Verify at the official NPI Registry.