Individual provider Active NPI

Ndeye Ndour

  • Certified Registered Nurse Anesthetist
  • Clovis, NM
National Provider Identifier
1659927283
Registry record updated Aug 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
57121 Issued in NM
Practice address
2100 N M.L.K. Jr Blvd
Clovis, NM 88101
Phone
(575) 769-2141
NPI assigned
Aug 9, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 57121 NM Primary

Addresses

Primary practice location

2100 N M.L.K. Jr Blvd
Clovis, NM 88101

Mailing address

2220 Ralph Boone
Clovis, NM 88101-9027
Phone (703) 347-3078

Other identifiers 1

IdentifierTypeStateIssuer
127222MedicaidNM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM, FL, CO3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20191016000100 NM Practitioner - Certified Registered Nurse Anesthetist (Crna) 5193055523 Reassigns benefits to 2 organizations
I20200727001326 FL Practitioner - Certified Registered Nurse Anesthetist (Crna) 5193055523 Reassigns benefits to 4 organizations
I20250916000114 CO Practitioner - Certified Registered Nurse Anesthetist (Crna) 5193055523 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Netherlands Anesthesia, LLCGroup PAC ID 8123433588, 41 clinicians
Ams National LLCGroup PAC ID 3870813025, 310 clinicians

Practice addresses (Care Compare)

104 Legion Dr
Las Vegas, NM 87701-4804
Phone (505) 426-3500

6002 Berryhill Rd
Milton, FL 32570-5062
Phone (850) 626-7762

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
57121NMMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Ams of Gulf Breeze LLC Nurse Anesthetist, Certified Registered CurrentSince Jul 1, 2020 Accepting new patients
Ams Baptist LLC Nurse Anesthetist, Certified Registered CurrentSince Jul 1, 2020 Accepting new patients
Clinical Colleagues Inc Nurse Anesthetist, Certified Registered CurrentSince Jul 4, 2025 Accepting new patients
Netherlands Anesthesia, LLC CurrentSince Nov 3, 2025 Accepting new patients
Ams National LLC Nurse Anesthetist, Certified Registered CurrentSince Apr 1, 2021 Accepting new patients
Clinical Colleagues Inc CurrentSince Sep 25, 2025 Accepting new patients
Cibola General Hospital Corporation Current Accepting new patients

Locations

1000 Lincoln St
Fort Morgan, CO 80701
Phone (970) 542-3320

524 W Sagamore Ave
Clewiston, FL 33440
Phone (800) 494-3984

6002 Berryhill Rd
Milton, FL 32570
Phone (850) 474-8688

1110 Gulf Breeze Pkwy
Pensacola Beach, FL 32561
Phone (850) 438-1848

10521 SW Village Center Dr
Ste 104
Port St Lucie, FL 34987
Phone (772) 345-8600

6733 Gall Blvd
Zephyrhills, FL 33542
Phone (813) 783-8242

601 Martin Luther King Ave NE
Albuquerque, NM 87102
Phone (505) 727-8040

1016 E Roosevelt Ave
Grants, NM 87020
Phone (505) 287-4446

104 Legion Dr
Las Vegas, NM 87701
Phone (505) 426-3500

Organizations & group practices 7

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.

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": "1565308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565308800000",
    "number": "1659927283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2220 RALPH BOONE",
            "city": "CLOVIS",
            "state": "NM",
            "postal_code": "881019027",
            "telephone_number": "703-347-3078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 N M.L.K. JR BLVD",
            "city": "CLOVIS",
            "state": "NM",
            "postal_code": "88101",
            "telephone_number": "575-769-2141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NDOUR",
        "first_name": "NDEYE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-09",
        "last_updated": "2019-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NM",
            "license": "57121",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "127222",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clovis, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.