Individual provider Active NPI

Jesse Daniel Acosta, FNP

  • Family Nurse Practitioner
  • Albuquerque, NM
National Provider Identifier
1720761695
Registry record updated Aug 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
75124 Issued in NM
Practice address
10501 Golf Course Rd NW
Albuquerque, NM 87114-5019
Phone
(505) 727-2000
NPI assigned
Aug 8, 2023
Last updated
Aug 8, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 75124 NM Primary

Addresses

Primary practice location

10501 Golf Course Rd NW
Albuquerque, NM 87114-5019

Mailing address

2425 Camino Seville SE
Rio Rancho, NM 87124-8851
Phone (505) 417-1397

Other practice location 1

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

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
I20231023000094 NM Practitioner - Nurse Practitioner 1456707801 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
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

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
75124NMMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Southwest Medical Associates, LLC CurrentSince Nov 1, 2023 Accepting new patients
Southwest Medical Associates, LLC CurrentSince Nov 1, 2023 Accepting new patients
Southwest Emergency Medical Associates of NM PC Nurse Practitioner CurrentSince Jan 1, 2025 Accepting new patients
Lovelace Health System, LLC Past Accepting new patients

Locations

10501 Golf Course Rd NW
Albuquerque, NM 87114
Phone (505) 727-2000

4101 Indian School Rd NE
Ste 110
Albuquerque, NM 87110
Phone (505) 727-8360

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

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

2450 S Telshor Blvd
Las Cruces, NM 88011
Phone (505) 522-8641

117 E 19th St
Roswell, NM 88201
Phone (505) 727-2000

Interoperability endpoints

  • Direct secure messaging: jacosta12320@ahs.direct-ci.com

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": "1691452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691452800000",
    "number": "1720761695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2425 CAMINO SEVILLE SE",
            "city": "RIO RANCHO",
            "state": "NM",
            "postal_code": "871248851",
            "telephone_number": "505-417-1397"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10501 GOLF COURSE RD NW",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871145019",
            "telephone_number": "505-727-2000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "601 Dr Martin Luther King Jr Ave NE",
            "address_purpose": "LOCATION",
            "city": "Albuquerque",
            "state": "NM",
            "postal_code": "871023619",
            "country_code": "US",
            "telephone_number": "505-727-8000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ACOSTA",
        "first_name": "JESSE",
        "middle_name": "DANIEL",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-08-08",
        "last_updated": "2023-08-08",
        "certification_date": "2023-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NM",
            "license": "75124",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.