Myrria Quintana, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA2022-0092 Issued in NM

Practice address

4010 Montgomery Blvd NE
Albuquerque, NM 87109-1186

Phone

(505) 275-4288

Fax

(505) 254-6532

NPI assigned

Feb 9, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mquintana120989@westdirect.optum.com

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.

• Optumcare New Mexico LLC

  • Family Medicine Physician
  • Albuquerque, NM
  • NPI 1124053210
  Medicare reassignment NPD
• Optumcare Endoscopy Center New Mexico, LLC

  • Ambulatory Surgical Clinic/Center
  • Albuquerque, NM
  • NPI 1962685834
  NPD (past)

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

{
    "created_epoch": "1675900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675900800000",
    "number": "1538866645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 26028",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871256028",
            "telephone_number": "505-262-7963",
            "fax_number": "505-232-1627"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4010 MONTGOMERY BLVD NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871091186",
            "telephone_number": "505-275-4288",
            "fax_number": "505-254-6532"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUINTANA",
        "first_name": "MYRRIA",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-09",
        "last_updated": "2023-02-09",
        "certification_date": "2023-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NM",
            "license": "PA2022-0092",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Justin Quintana
• Kathie Quintana, LCSW
• Kiley Quintana
• Marissa Quintana
• Michaela Quintana
• Oscar Christopher Quintana, DDS
• Quentin Quintana, CPSW
• Reese Quintana
• Rhonda Anna Quintana
• Rhonda J Quintana

• Physician Assistant in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Physician Assistant in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.