Ambeson Cornell Ambe

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

CNP74900 Issued in NM

Practice address

6100 Indian School Rd NE Ste 115
Albuquerque, NM 87110-4181

Phone

(505) 881-4500

NPI assigned

May 15, 2023

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in OK

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

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lifestancehealth.ambesonambe@136732.advancedmd-direct.com

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.

• Evizzit of Iowa Psychiatry PC

  • Psychiatry Physician
  • West Des Moines, IA
  • NPI 1740841188

  OK, Psychiatric/Mental Health

  Medicare reassignment NPD
• Reliance Mental Health Clinic

  • Family Medicine Physician
  • Bethany, OK
  • NPI 1124705348

  Psychiatric/Mental Health

  Medicare reassignment NPD
• Enchantment Healthcare Partners LLC

  • Nurse Practitioner
  • Albuquerque, NM
  • NPI 1154094613
  NPD (past)
• Mark B. Privott, O.D., Inc

  • Optometrist
  • Bethany, OK
  • NPI 1225257249
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1684108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787616000000",
    "number": "1730879545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6100 INDIAN SCHOOL RD NE STE 115",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871104181",
            "telephone_number": "505-881-4500",
            "fax_number": "505-881-5158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6100 INDIAN SCHOOL RD NE STE 115",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871104181",
            "telephone_number": "505-881-4500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4825 Alliance Blvd Ste 150",
            "address_purpose": "LOCATION",
            "city": "Plano",
            "state": "TX",
            "postal_code": "750935577",
            "country_code": "US",
            "telephone_number": "844-824-8775",
            "fax_number": "281-648-2200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AMBE",
        "first_name": "AMBESON",
        "middle_name": "CORNELL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-05-15",
        "last_updated": "2026-08-25",
        "certification_date": "2026-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OK",
            "license": "215093",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NM",
            "license": "CNP74900",
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "1118807",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Clare R. Amato, CRNA
• Damian Amaya
• Ilse Gisselle Amaya
• Julie Amaya
• Ricardo Amaya, DPT
• Chenwi Ambe, MD
• Ambercare Hospice, Inc.
• Ambercare Medical Supply Company
• Yvonne Amberman
• Saima Ambreen

• Psychiatric/Mental Health Nurse Practitioner in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Psychiatric/Mental Health Nurse Practitioner in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.