Andrew Thomas Theus, PA-C
Individual provider Active NPI Physician Assistant · Estancia, NM
NPI 1568029239 · NPPES record last updated Jul 16, 2019
Key facts
- NPI
- 1568029239
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- PA2019-0052 (NM)
- Practice address
- 903 5TH St # C
Estancia, NM 87016-1155 - Phone
- (505) 384-2777
- NPI assigned
- May 28, 2019
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 6
Hospital & facility affiliations 2
Medicare Care Compare profile
- 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 Services
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
- Presbyterian Hospital
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 ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190808000217 | NM | Practitioner - Physician Assistant | 1153658562 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA2019-0052 | NM | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Presbyterian Medical Services | Current |
Accepting new patients | |
| Presbyterian Medical Services | Current |
Accepting new patients | |
| Presbyterian Healthcare Services | Current |
Accepting new patients | |
| Presbyterian Healthcare Services | Current |
Accepting new patients | |
| Presbyterian Healthcare Services | Past | Accepting new patients |
Locations
1100 Lead Ave SE
Albuquerque, NM 87106
Phone (505) 224-7000
301 Cedar St SE
Albuquerque, NM 87106
Phone (505) 224-7000
1100 Central Ave SE
Albuquerque, NM 87106
Phone (505) 724-6124
2200 W 21st St
Clovis, NM 88101
Phone (505) 769-7577
2400 Unser Blvd SE
Ste 19100A
Rio Rancho, NM 87124
Phone (505) 224-7000
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
1422 Paseo de Peralta
Santa Fe, NM 87501
Phone (505) 982-5565
Interoperability endpoints
- atheus227494@direct.phs.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA2019-0052 | NM | Yes |
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
Other providers in Estancia, NM
- Jacquelyn Sanchez
- Soulshine at Native Hills
- Nancy Spreitzer
- Linda Marie Stogner
- April Tapia
- Town of Estancia
- Maryann Wadden
- Bernadette Dina Wells
- Louise A White
- Karen S Zakar
All providers in Estancia, NM · Physician Assistant 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 Jul 16, 2019. 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).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.