Individual provider Active NPI

Erin Dawn Moenaert, FNP-BC-FNP-C

  • Family Nurse Practitioner
  • Rio Rancho, NM
National Provider Identifier
1790423952
Registry record updated May 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
99999999 Issued in NM
Practice address
1316 Jackie Rd SE Ste 500
Rio Rancho, NM 87124-6607
Phone
(505) 415-0719
Fax
(505) 372-0093
NPI assigned
May 26, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 26, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 99999999 NM Primary

Addresses

Primary practice location

1316 Jackie Rd SE Ste 500
Rio Rancho, NM 87124-6607

Mailing address

1316 Jackie Rd SE Ste 500
Rio Rancho, NM 87124-6607
Phone (505) 415-0719

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
I20220901002344 NM Practitioner - Nurse Practitioner 8022492545 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
99999999NMMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
G & M Medical Center CurrentSince Oct 1, 2022 Accepting new patients
Albuquerque Urgent Care Walk in Clinic PC CurrentSince Nov 14, 2022 Accepting new patients

Locations

14671 Telegraph Rd
Redford, MI 48239
Phone (313) 387-2100

5850 Eubank Blvd NE
Ste B32
Albuquerque, NM 87111
Phone (505) 200-2860

1316 Jackie Rd SE
Ste 500
Rio Rancho, NM 87124
Phone (505) 415-0719

1316 Jackie Rd SE
Ste 400
Rio Rancho, NM 87124
Phone (505) 234-1612

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1653523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653523200000",
    "number": "1790423952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1316 JACKIE RD SE STE 500",
            "city": "RIO RANCHO",
            "state": "NM",
            "postal_code": "871246607",
            "telephone_number": "505-415-0719",
            "fax_number": "505-372-0093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1316 JACKIE RD SE STE 500",
            "city": "RIO RANCHO",
            "state": "NM",
            "postal_code": "871246607",
            "telephone_number": "505-415-0719",
            "fax_number": "505-372-0093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOENAERT",
        "first_name": "ERIN",
        "middle_name": "DAWN",
        "credential": "FNP-BC-FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-26",
        "last_updated": "2022-05-26",
        "certification_date": "2022-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NM",
            "license": "99999999",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rio Rancho, NM

Sources for this page

Verify at the official NPI Registry.