Individual provider Active NPI

Kristin Benavidez, FNP, MSN, RN

  • Family Nurse Practitioner
  • Clovis, NM
National Provider Identifier
1689268450
Registry record updated Mar 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
63137 Issued in NM
Practice address
2200 W 21St St
Clovis, NM 88101-2011
Phone
(575) 769-7577
NPI assigned
Feb 23, 2021
Last updated
Mar 15, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 63137 NM Primary
Administrator Registered Nurse 163WA2000X R65541 NM
Emergency Registered Nurse 163WE0003X R65541 NM

Addresses

Primary practice location

2200 W 21St St
Clovis, NM 88101-2011

Mailing address

2200 W 21St St
Clovis, NM 88101-2011
Phone (575) 769-7577

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
I20210407000072 NM Practitioner - Nurse Practitioner 4688081888 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Fedko Emergency Physicians New Mexico, LLCGroup PAC ID 4880934389, 53 clinicians
Presbyterian Healthcare ServicesGroup PAC ID 9234041708, 1,390 clinicians

Practice addresses (Care Compare)

1016 E Rooselvelt Ave
Grants, NM 87020-2118
Phone (505) 287-4446

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

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.68 of 100Reported as group
Quality
82.35
Promoting interoperability
100
Improvement activities
40
Cost
76.6

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
R65541NMMDEmergency Registered Nurse
63137NMMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Presbyterian Healthcare Services CurrentSince May 11, 2021 Accepting new patients
Presbyterian Healthcare Services CurrentSince May 11, 2021 Accepting new patients
Fedko Emergency Physicians New Mexico LLC CurrentSince Dec 1, 2024 Accepting new patients
Presbyterian Healthcare Services Past Accepting new patients

Locations

4588 Paradise Blvd NW
Albuquerque, NM 87114
Phone (505) 923-2070

2100 N Mlk Blvd
Clovis, NM 88101
Phone (505) 769-2141

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

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

Interoperability endpoints

  • Direct secure messaging: kbenavidez45480@direct.phs.org

Organizations & group practices 4

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 3

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": "1614038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615766400000",
    "number": "1689268450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 W 21ST ST",
            "city": "CLOVIS",
            "state": "NM",
            "postal_code": "881012011",
            "telephone_number": "575-769-7577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 W 21ST ST",
            "city": "CLOVIS",
            "state": "NM",
            "postal_code": "881012011",
            "telephone_number": "575-769-7577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENAVIDEZ",
        "first_name": "KRISTIN",
        "name_prefix": "Mrs.",
        "credential": "FNP, MSN, RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-23",
        "last_updated": "2021-03-15",
        "certification_date": "2021-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NM",
            "license": "63137",
            "primary": true
        },
        {
            "code": "163WA2000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Administrator",
            "state": "NM",
            "license": "R65541",
            "primary": false
        },
        {
            "code": "163WE0003X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Emergency",
            "state": "NM",
            "license": "R65541",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clovis, NM

Sources for this page

Verify at the official NPI Registry.