Jonathon Michael Lavalley, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA2013-0089 Issued in NM

Practice address

1423 E Roosevelt Ave
Grants, NM 87020-2245

Phone

(505) 287-6500

Fax

(505) 287-5393

NPI assigned

Jan 12, 2014

Last updated

Jan 12, 2014By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Physician Assistant

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Presbyterian Medical ServicesGroup PAC ID 2062324684, 132 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Cibola General Hospital Hospital, Grants, NM, CCN 321308

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jonathon.lavalley.p1@direct.pmsnm.nextgenshare.com

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.

• Presbyterian Medical Services

  dba Rio Rancho Family Health Center

  • Federally Qualified Health Center (FQHC)
  • Rio Rancho, NM
  • NPI 1871505032
  Medicare reassignment Care Compare group
• Cibola General Hospital Corporation

  dba Cibola General Hospital

  • Critical Access Hospital
  • Grants, NM
  • NPI 1780677039
  Medicare reassignment
• Presbyterian Medical Services

  dba PMS Central Pharmacy

  • Community/Retail Pharmacy
  • Albuquerque, NM
  • NPI 1306654462
  NPD
• Presbyterian Medical Services

  dba Pecos Valley Medical Center

  • Federally Qualified Health Center (FQHC)
  • Pecos, NM
  • NPI 1922656404
  NPD
• Cibola General Hospital Corporation

  dba Cibola Family Health Center

  • Rural Health Clinic/Center
  • Grants, NM
  • NPI 1457675266
  NPD (past)
• Presbyterian Medical Services

  • Federally Qualified Health Center (FQHC)
  • Santa Fe, NM
  • NPI 1518910553
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Cibola General Hospital Corporation

  dba Cibola General Hospital

  • Critical Access Hospital
  • Grants, NM
  • NPI 1780677039
  Care Compare affiliation

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

{
    "created_epoch": "1389484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1389484800000",
    "number": "1871915702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1423 E ROOSEVELT AVE",
            "city": "GRANTS",
            "state": "NM",
            "postal_code": "870202245",
            "telephone_number": "505-363-5126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1423 E ROOSEVELT AVE",
            "city": "GRANTS",
            "state": "NM",
            "postal_code": "870202245",
            "telephone_number": "505-287-6500",
            "fax_number": "505-287-5393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAVALLEY",
        "first_name": "JONATHON",
        "middle_name": "MICHAEL",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-01-12",
        "last_updated": "2014-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NM",
            "license": "PA2013-0089",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Rodney Alan Lente
• Melissa A Leyba, LMSW

• Physician Assistant in Grants, NM
• Providers in Grants, NM by specialty
• Physician Assistant in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.