Ana L Tesh, NURSE PRACTITIONER
Individual provider Active NPI Family Nurse Practitioner · Acoma, NM
NPI 1457412934 · NPPES record last updated May 17, 2023
Key facts
- NPI
- 1457412934
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- RN140783 (GA)
- Practice address
- 80 B Veterans Blvd
Acoma, NM 87034 - Phone
- (505) 552-5300
- Fax
- (505) 552-5490
- NPI assigned
- Dec 12, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20241126000718 | GA | Order and Referring Only - Nurse Practitioner | 1052693108 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nuestros Ninos Our Kids Pediatrics Inc. | Family | Past | Accepting new patients |
Interoperability endpoints
- ms_atesh@landmarkhealth-direct.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | RN140783 | GA | Yes |
Addresses
Primary practice location
80 B Veterans Blvd
Acoma, NM 87034
Mailing address
P.O. Box 130
San Fidel, NM 87049-0130
Phone (505) 552-5300
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| H3451 | Medicaid | NM |
Other providers in Acoma, NM
- Lisa S Schuerman
- Hlengiwe Lindani Sibanda
- Philip E Stein
- Korey B Still
- Karen Marlene Tenorio
- Brian Tieu
- Nadezda A Tretyakova
- I-Wen Tseng
- Edwina Valdo
- Jennifer Vallo
All providers in Acoma, NM · Family Nurse Practitioner in New Mexico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 17, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.