Individual provider Active NPI

Emily Jeanne Bryl, PA

  • Physician Assistant
  • Albuquerque, NM
National Provider Identifier
1851743942
Registry record updated Apr 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
5120 Masthead St NE
Albuquerque, NM 87109-4366
Phone
(505) 243-7546
Fax
(505) 243-7547
NPI assigned
Jul 13, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X PA20160066 NM
Physician Assistant 363A00000X NM Primary

Addresses

Primary practice location

5120 Masthead St NE
Albuquerque, NM 87109-4366

Mailing address

5120 Masthead St NE
Albuquerque, NM 87109-4366
Phone (505) 243-7546

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
I20170213001785 NM Practitioner - Physician Assistant 4284917410 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dermatology and Skin Cancer Center of NM PCGroup PAC ID 9234238775, 8 clinicians

Practice addresses (Care Compare)

5120 Masthead St NE
Albuquerque, NM 87109-4366
Phone (505) 243-7546

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

Merit-based Incentive Payment System (MIPS)

Final score
99.17 of 100Reported as group
Quality
98.33
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA20160066NMMDDermatology Physician

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": "1468368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714435200000",
    "number": "1851743942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5120 MASTHEAD ST NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871094366",
            "telephone_number": "505-243-7546",
            "fax_number": "505-243-7547"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5120 MASTHEAD ST NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871094366",
            "telephone_number": "505-243-7546",
            "fax_number": "505-243-7547"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRYL",
        "first_name": "EMILY",
        "middle_name": "JEANNE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-13",
        "last_updated": "2024-04-30",
        "certification_date": "2024-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NM",
            "license": "PA20160066",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NM",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.