Individual provider Active NPI

Andrew Thomas Theus, PA-C

  • Physician Assistant
  • Estancia, NM
National Provider Identifier
1568029239
Registry record updated Jul 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA2019-0052 Issued in NM
Practice address
903 5TH St # C
Estancia, NM 87016-1155
Phone
(505) 384-2777
NPI assigned
May 28, 2019
Last updated
Jul 16, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2019

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 PA2019-0052 NM Primary

Addresses

Primary practice location

903 5TH St # C
Estancia, NM 87016-1155

Mailing address

PO Box 305
Edgewood, NM 87015-0305
Phone (706) 575-8004

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
I20190808000217 NM Practitioner - Physician Assistant 1153658562 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Presbyterian Healthcare ServicesGroup PAC ID 9234041708, 1,390 clinicians

Practice addresses (Care Compare)

1100 Lead Ave SE
Albuquerque, NM 87106-5215
Phone (505) 224-7000

2200 W 21St St
Clovis, NM 88101-2011
Phone (505) 769-7577

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA2019-0052NMMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Presbyterian Healthcare Services CurrentSince Feb 21, 2023 Accepting new patients
Presbyterian Healthcare Services CurrentSince Feb 21, 2023 Accepting new patients
Presbyterian Medical Services CurrentSince Jul 15, 2019 Accepting new patients
Presbyterian Medical Services CurrentSince Jul 15, 2019 Accepting new patients
Presbyterian Healthcare Services Past Accepting new patients

Locations

1100 Central Ave SE
Albuquerque, NM 87106
Phone (505) 724-6124

1100 Lead Ave SE
Albuquerque, NM 87106
Phone (505) 224-7000

301 Cedar St SE
Albuquerque, NM 87106
Phone (505) 224-7000

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

2400 Unser Blvd SE
Rio Rancho, NM 87124
Phone (505) 253-0000

2400 Unser Blvd SE
Ste 19100
Rio Rancho, NM 87124
Phone (505) 224-7000

2400 Unser Blvd SE
Ste 19100A
Rio Rancho, NM 87124
Phone (505) 224-7000

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

Interoperability endpoints

  • Direct secure messaging: atheus227494@direct.phs.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1559001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563235200000",
    "number": "1568029239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 305",
            "city": "EDGEWOOD",
            "state": "NM",
            "postal_code": "870150305",
            "telephone_number": "706-575-8004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "903 5TH ST # C",
            "city": "ESTANCIA",
            "state": "NM",
            "postal_code": "870161155",
            "telephone_number": "505-384-2777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THEUS",
        "first_name": "ANDREW",
        "middle_name": "THOMAS",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-05-28",
        "last_updated": "2019-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NM",
            "license": "PA2019-0052",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Estancia, NM

Sources for this page

Verify at the official NPI Registry.