Active NPI
Tilly Ngo
- Pediatrics Physician
- Rio Rancho, NM
National Provider Identifier
1740743871
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- MD2022-1118
- Practice address
- 4005 High Resort Blvd SE
Rio Rancho, NM 87124-5906 - Phone
- (505) 462-6000
- NPI assigned
- Apr 6, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | MD2022-1118 | NM | Primary |
Addresses
Primary practice location
4005 High Resort Blvd SE
Rio Rancho, NM 87124-5906
Mailing address
4005 High Resort Blvd SE
Rio Rancho, NM 87124-5906
Other practice location 1
Msc 10-5590 1 University Of New Mexico
Albuquerque, NM 87131-0001
Phone (505) 272-5551
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: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Presbyterian Healthcare Services | Current | Accepting new patients | |
| Presbyterian Healthcare Services | Pediatrics | Current | Accepting new patients |
| Presbyterian Healthcare Services | Past | Accepting new patients |
Locations
2200 W 21st St
Clovis, NM 88101
Phone (505) 769-7577
4005 High Resort Blvd SE
Rio Rancho, NM 87124
Phone (505) 462-6000
Interoperability endpoints
- tngo219084@direct.phs.org
Organizations & group practices 3
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.
-
dba Presbyterian Medical Group
- Internal Medicine Physician
- Albuquerque, NM
- NPI 1104802354
Pediatrics
-
dba Presbyterian Hospital
- General Acute Care Hospital
- Albuquerque, NM
- NPI 1215913470
-
dba Espanola Hospital
- Rural Acute Care Hospital
- Espanola, NM
- NPI 1154307593
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1554508800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1719273600000",
"number": "1740743871",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4005 HIGH RESORT BLVD SE",
"city": "RIO RANCHO",
"state": "NM",
"postal_code": "871245906"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4005 HIGH RESORT BLVD SE",
"city": "RIO RANCHO",
"state": "NM",
"postal_code": "871245906",
"telephone_number": "505-462-6000"
}
],
"practiceLocations": [
{
"address_1": "Msc 10-5590 1 University Of New Mexico",
"address_purpose": "LOCATION",
"city": "Albuquerque",
"state": "NM",
"postal_code": "871310001",
"country_code": "US",
"telephone_number": "505-272-5551",
"fax_number": "505-272-6845",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "NGO",
"first_name": "TILLY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-04-06",
"last_updated": "2024-06-25",
"certification_date": "2024-06-25",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NM",
"license": "MD2022-1118",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rio Rancho, NM
- New Mexico Professional Dental Associates, Inc (Rio Rancho Dental Arts)
- New Mexico Wellness
- New Mexico Wellness
- New Mexico Wellness Center LLC (Stefanie Juliano Therapy)
- New Vision Behavioral Health, LLC
- Emily Trang Nguyen, OD
- Kimberly Nguyen, MD
- Lisa Nguyen, RPH
- Nicole Green LLC (Nicole Green Counseling & Wellness)
- Meighen Nieto, LMSW
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2024; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.