Individual provider Active NPI

Marianna Antonina Maurello, PA-C

  • Physician Assistant
  • Albuquerque, NM
National Provider Identifier
1790309722
Registry record updated Jul 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA2022-0080 Issued in NM
Practice address
2211 Lomas Blvd NE
Albuquerque, NM 87106-2719
Phone
(505) 272-2111
NPI assigned
Jun 5, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 16, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Physician Assistant 363A00000X PA2022-0080 NM Primary

Addresses

Primary practice location

2211 Lomas Blvd NE
Albuquerque, NM 87106-2719

Mailing address

12200 Montgomery Blvd NE Apt B104
Albuquerque, NM 87111-4101
Phone (970) 699-8257

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address UNMH@direct.health.unm.edu
Direct Messaging Address UNMMG@direct.health.unm.edu

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
I20221025002292 NM Practitioner - Physician Assistant 8628444106 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Unm HospitalGroup PAC ID 7618889528, 394 clinicians

Practice addresses (Care Compare)

2211 Lomas Blvd NE
Albuquerque, NM 87106-2719
Phone (505) 272-2644

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.64 of 100Reported as group
Quality
75.49
Promoting interoperability
100
Improvement activities
40
Cost
76.92

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Unm Hospital CurrentSince Jul 1, 2025 Accepting new patients
Unm Medical Group, Inc. CurrentSince Sep 27, 2022 Accepting new patients

Locations

933 Bradbury Dr SE
Ste 2222
Albuquerque, NM 87106
Phone (505) 272-1476

2211 Lomas Blvd NE
Unm, NM 87106
Phone (505) 272-1111

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 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": "1591315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721088000000",
    "number": "1790309722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12200 MONTGOMERY BLVD NE APT B104",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871114101",
            "telephone_number": "970-699-8257"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2211 LOMAS BLVD NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871062719",
            "telephone_number": "505-272-2111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAURELLO",
        "first_name": "MARIANNA",
        "middle_name": "ANTONINA",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-06-05",
        "last_updated": "2024-07-16",
        "certification_date": "2024-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NM",
            "license": "PA2022-0080",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "UNMH@direct.health.unm.edu",
            "affiliation": "N",
            "address_1": "2211 Lomas Blvd NE",
            "city": "Albuquerque",
            "state": "NM",
            "country_code": "US",
            "postal_code": "871062719",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "UNMMG@direct.health.unm.edu",
            "affiliation": "N",
            "address_1": "800 Bradbury Dr SE Ste 116",
            "city": "Albuquerque",
            "state": "NM",
            "country_code": "US",
            "postal_code": "871064310",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.