Individual provider Active NPI

Jennifer L Tso, PA-C

  • Physician Assistant
  • Albuquerque, NM
National Provider Identifier
1598843146
Registry record updated Oct 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA20060036 Issued in NM
Practice address
504 Elm St NE
Albuquerque, NM 87102-2512
Phone
(505) 841-1000
NPI assigned
Nov 1, 2006
Last updated
Oct 9, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2024

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 PA20060036 NM Primary

Addresses

Primary practice location

504 Elm St NE
Albuquerque, NM 87102-2512

Mailing address

407 S Schwartz Ave
Suite 101
Farmington, NM 87401-5954
Phone (505) 609-6770

Other practice location 1

407 S Schwartz Ave
Suite 101
Farmington, NM 87401-5954
Phone (505) 609-6770

Other identifiers 4

IdentifierTypeStateIssuer
81427212MedicaidNM
PA2006-0036OtherNM LICENSE
PENDINGMedicaidCO
PENDINGMedicaidAZ

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
I20091009000473 NM Practitioner - Physician Assistant 7810996477 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southwest Medical Associates, LLCGroup PAC ID 7214831114, 326 clinicians

Practice addresses (Care Compare)

601 Dr Martin Luther King Jr Ave NE
Albuquerque, NM 87102-3619
Phone (505) 727-8000

715 Dr Martin Luther King Jr Ave NE
Suite 301
Albuquerque, NM 87102-3668
Phone (505) 727-7090

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA20060036NMMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
San Juan Regional Medical Center Inc CurrentSince Jan 7, 2015 Accepting new patients
Southwest Medical Associates, LLC CurrentSince Sep 1, 2024 Accepting new patients
Southwest Medical Associates, LLC CurrentSince Sep 1, 2024 Accepting new patients
San Juan Regional Medical Center Inc CurrentSince Jan 7, 2015 Accepting new patients

Locations

504 Elm St NE
Albuquerque, NM 87102
Phone (505) 724-2000

715 Martin Luther King Ave NE
Ste 301
Albuquerque, NM 87102
Phone (505) 727-4500

407 S Schwartz Ave
Ste 101
Farmington, NM 87401
Phone (505) 609-6595

407 S Schwartz Ave
Ste 202
Farmington, NM 87401
Phone (505) 609-6595

4820 E Main St
Ste 2
Farmington, NM 87402
Phone (505) 609-6610

Interoperability endpoints

  • Direct secure messaging: jtso331400@ahs.direct-ci.com

Organizations & group practices 5

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": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728432000000",
    "number": "1598843146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "407 S SCHWARTZ AVE",
            "address_2": "SUITE 101",
            "city": "FARMINGTON",
            "state": "NM",
            "postal_code": "874015954",
            "telephone_number": "505-609-6770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "504 ELM ST NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871022512",
            "telephone_number": "505-841-1000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "407 S Schwartz Ave",
            "address_2": "Suite 101",
            "address_purpose": "LOCATION",
            "city": "Farmington",
            "state": "NM",
            "postal_code": "874015954",
            "country_code": "US",
            "telephone_number": "505-609-6770",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TSO",
        "first_name": "JENNIFER",
        "middle_name": "L",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-01",
        "last_updated": "2024-10-09",
        "certification_date": "2024-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NM",
            "license": "PA20060036",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "81427212",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NM LICENSE",
            "identifier": "PA2006-0036",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.