Active NPI
Elizabeth C. Dyer, CRNA
- Certified Registered Nurse Anesthetist
- Santa Fe, NM
National Provider Identifier
1770528507
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- R28511
- Practice address
- 455 Saint Michaels Dr
Santa Fe, NM 87505-7601 - Phone
- (505) 820-5554
- Fax
- (505) 946-3173
- NPI assigned
- Jun 17, 2006
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | R28511 | NM | Primary |
Addresses
Primary practice location
455 Saint Michaels Dr
Santa Fe, NM 87505-7601
Mailing address
455 Saint Michaels Dr
Santa Fe, NM 87505-7601
Phone (505) 820-5554
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 93708 | Medicaid | NM | |
| 202005689 | Other | NM | PHP MOO SALUD |
| 363094 | Medicaid | AZ |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NM
Enrollment records 1
Care Compare profile
Medicare Care CompareMerit-based Incentive Payment System (MIPS)
- Final score
- 84.34 of 100
- Quality
- 77.27
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 70.54
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southwest Gastroenterology Associates | Current | Accepting new patients | |
| Main Street Anesthesia of New Mexico, LLC | Current | Accepting new patients | |
| Anesthesia Associates of New Mexico P C | Past | Accepting new patients |
Locations
7788 Jefferson St NE
Albuquerque, NM 87109
Phone (505) 999-1600
117 E 19th St
Roswell, NM 88201
Phone (505) 727-2000
Interoperability endpoints
- https://api.platform.athenahealth.com/12517/brand/1/csg/1/fhir/r4
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.
-
- Anesthesiology Physician
- Albuquerque, NM
- NPI 1275010985
-
- Specialist
- Albuquerque, NM
- NPI 1902931728
-
- Specialist
- Albuquerque, NM
- NPI 1912900754
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150502400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1287100800000",
"number": "1770528507",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "455 SAINT MICHAELS DR",
"city": "SANTA FE",
"state": "NM",
"postal_code": "875057601",
"telephone_number": "505-820-5554",
"fax_number": "505-946-3173"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "455 SAINT MICHAELS DR",
"city": "SANTA FE",
"state": "NM",
"postal_code": "875057601",
"telephone_number": "505-820-5554",
"fax_number": "505-946-3173"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DYER",
"first_name": "ELIZABETH",
"middle_name": "C.",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-17",
"last_updated": "2010-10-15",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "NM",
"license": "R28511",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "93708",
"state": "NM"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHP MOO SALUD",
"identifier": "202005689",
"state": "NM"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "363094",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Santa Fe, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- 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.