Individual provider Active NPI

Austin Lorgan Tarantello, PA-C

  • Physician Assistant
  • Albuquerque, NM
National Provider Identifier
1780342907
Registry record updated Dec 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA2023-0234 Issued in NM
Practice address
1500 N Renaissance Blvd NE Ste C
Albuquerque, NM 87107-7002
Phone
(505) 266-5565
NPI assigned
Dec 5, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA2023-0234 NM Primary

Addresses

Primary practice location

1500 N Renaissance Blvd NE Ste C
Albuquerque, NM 87107-7002

Mailing address

1500 N Renaissance Blvd NE Ste C
Albuquerque, NM 87107-7002
Phone (505) 266-5565

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
I20231024002619 NM Practitioner - Physician Assistant 1951757137 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Presbyterian Healthcare ServicesGroup PAC ID 9234041708, 1,390 clinicians

Practice addresses (Care Compare)

4515 Coors Blvd NW
Albuquerque, NM 87120-3699
Phone (505) 596-2200

8300 Constitution Ave NE
Albuquerque, NM 87110-7613

Hospital & facility affiliations

  • Presbyterian Hospital Hospital, Albuquerque, NM, CCN 320021

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
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA2023-0234NMMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Presbyterian Healthcare Services CurrentSince Sep 12, 2023 Accepting new patients
Presbyterian Healthcare Services CurrentSince Sep 12, 2023 Accepting new patients
Presbyterian Healthcare Services Past Accepting new patients

Locations

3436 Isleta Blvd SW
Albuquerque, NM 87105
Phone (505) 462-7777

8300 Constitution Ave NE
Bldg D
Albuquerque, NM 87110
Phone (505) 291-2200

1100 Central Ave SE
Albuquerque, NM 87106
Phone (505) 724-6124

8300 Constitution Ave NE
Albuquerque, NM 87110
Phone (505) 291-2000

4515 Coors Blvd NW
Albuquerque, NM 87120
Phone (505) 596-2200

6400 Paseo del Norte NE
Albuquerque, NM 87113
Phone (505) 596-2100

Interoperability endpoints

  • Direct secure messaging: atarantello129506@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.

Hospital & facility affiliations 2

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": "1638662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703635200000",
    "number": "1780342907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 N RENAISSANCE BLVD NE STE C",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871077002",
            "telephone_number": "505-266-5565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 N RENAISSANCE BLVD NE STE C",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871077002",
            "telephone_number": "505-266-5565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TARANTELLO",
        "first_name": "AUSTIN",
        "middle_name": "LORGAN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-12-05",
        "last_updated": "2023-12-27",
        "certification_date": "2023-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NM",
            "license": "PA2023-0234",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.