Individual provider Active NPI

Alyssa Meghan Marquez, PA-C

  • Physician Assistant
  • Durango, CO
National Provider Identifier
1821613738
Registry record updated Sep 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA.0006409 Issued in CO
Practice address
575 Rivergate LN
Durango, CO 81301-7487
Phone
(970) 247-3575
NPI assigned
Jun 16, 2020
Last updated
Sep 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 21, 2022

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 PA.0006409 CO Primary

Addresses

Primary practice location

575 Rivergate LN
Durango, CO 81301-7487

Mailing address

575 Rivergate LN Unit 100
Durango, CO 81301-7488

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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
I20200708001231 CO Practitioner - Physician Assistant 1355764440 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Animas Surgical Hospital LLCGroup PAC ID 0143295428, 61 clinicians

Practice addresses (Care Compare)

575 Rivergate
Unit 204
Durango, CO 81301-7490
Phone (970) 403-1340

575 Rivergate LN
Durango, CO 81301-7487
Phone (970) 247-3537

575 Rivergate LN
Unit 105
Durango, CO 81301-7490
Phone (970) 259-3020

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Animas Surgical Hospital, LLC CurrentSince Jun 23, 2022 Accepting new patients
Durango Surgery Center LLC CurrentSince Jun 23, 2022 Accepting new patients
Animas Surgical Hospital, LLC Past Accepting new patients
Animas Surgical Hospital, LLC Physician Assistant Past Accepting new patients

Locations

450 S Camino del Rio
Ste 106
Durango, CO 81301
Phone (970) 259-9311

575 Rivergate Ln
Durango, CO 81301
Phone (719) 648-5678

575 Rivergate Ln
Unit 100
Durango, CO 81301

575 Rivergate Ln
Unit 204
Durango, CO 81301
Phone (970) 382-8292

6128 S Lyncrest Ave
Sioux Falls, SD 57108
Phone (605) 334-1363

6330 S Western Ave
Ste 150
Sioux Falls, SD 57108

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 8

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": "1592265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663718400000",
    "number": "1821613738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "575 RIVERGATE LN UNIT 100",
            "city": "DURANGO",
            "state": "CO",
            "postal_code": "813017488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "575 RIVERGATE LN",
            "city": "DURANGO",
            "state": "CO",
            "postal_code": "813017487",
            "telephone_number": "970-247-3575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARQUEZ",
        "first_name": "ALYSSA",
        "middle_name": "MEGHAN",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-06-16",
        "last_updated": "2022-09-21",
        "certification_date": "2022-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "PA.0006409",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Durango, CO

Sources for this page

Verify at the official NPI Registry.