Eileen Claire Monyok, PA-C
Individual provider Active NPI Physician Assistant · Dulce, NM
NPI 1679561955 · NPPES record last updated Mar 7, 2023
Key facts
- NPI
- 1679561955
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- PA.0001967 (CO)
- Practice address
- 500 N Mundo
Dulce, NM 87528 - Phone
- (575) 759-3291
- Fax
- (575) 759-3651
- NPI assigned
- Oct 11, 2005
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 6
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in CO, TX
- 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 |
|---|---|---|---|---|
| I20041101000857 | CO | Practitioner - Physician Assistant | 4385606490 | Reassigns benefits to 1 organization |
| I20220412001047 | TX | Practitioner - Physician Assistant | 4385606490 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Clinica Campesina Family Health Services | Current |
Accepting new patients | |
| Jicarilla IHS Pharmacy | Current |
Accepting new patients | |
| Clinica Campesina Family Health Services | Current |
Accepting new patients | |
| Clinica Campesina Family Health Services | Past | Accepting new patients |
Locations
1735 S Public Rd
Ste 203
Lafayette, CO 80026
1735 S Public Rd
Ste 100
Lafayette, CO 80026
Phone (303) 665-2962
1735 S Public Rd
Lafayette, CO 80026
Phone 30366530361061
1345 Plaza Ct N
Ste 1A
Lafayette, CO 80026
Phone (303) 665-2962
2000 W South Boulder Rd
Lafayette, CO 80026
Phone 30366530361250
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA.0001967 | CO | Yes |
Addresses
Primary practice location
500 N Mundo
Dulce, NM 87528
Mailing address
PO Box 187
Dulce, NM 87528-0187
Phone (575) 759-3291
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 79970516 | Medicaid | CO |
Other providers in Dulce, NM
- Marie S March
- Richard Allen March
- Maureen C Margiotta
- Lloyd Merino
- Cynthia M. Montanez
- Phyllis Diane Morehead
- Northwest Reional Education Coop #2
- Amit M Patel
- Darlene Peshlakai Valdez
- Steven John Petrakis
All providers in Dulce, 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 Mar 7, 2023. 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).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.