Individual provider Active NPI

Erica Lankenau, PA

  • Surgical Physician Assistant
  • Farmington, NM
National Provider Identifier
1891150108
Registry record updated Jul 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA2015-0082 Issued in NM
Practice address
630 W Maple St
Farmington, NM 87401-6113
Phone
(505) 609-6300
Fax
(505) 609-6301
NPI assigned
Dec 31, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 1130229 NM
Surgical Physician Assistant 363AS0400X PA2015-0082 NM Primary

Addresses

Primary practice location

630 W Maple St
Farmington, NM 87401-6113

Mailing address

PO Box 6210
Farmington, NM 87499-6210
Phone (505) 609-2258

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
I20160212000129 NM Practitioner - Physician Assistant 4082918990 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
San Juan Regional Medical Center, Inc.Group PAC ID 4587559505, 233 clinicians

Practice addresses (Care Compare)

407 S Schwartz Ave
Farmington, NM 87401-5925

630 W Maple St
SJHP Gastroenterology
Farmington, NM 87401-6113
Phone (505) 609-6349

735 W Animas St
SJR General Surgeons
Farmington, NM 87401-6113
Phone (505) 609-6300

801 W Maple St
Farmington, NM 87401-5630

Hospital & facility affiliations

  • San Juan Regional Medical Center Inc Hospital, Farmington, NM, CCN 320005

Merit-based Incentive Payment System (MIPS)

Final score
90.97 of 100Reported as group
Quality
79.73
Promoting interoperability
100
Improvement activities
40
Cost
78.87

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1130229NMMDSurgical Physician Assistant
PA2015-0082NMMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
San Juan Regional Medical Center Inc CurrentSince Jan 4, 2016 Accepting new patients
San Juan Regional Medical Center Inc CurrentSince Jan 4, 2016 Accepting new patients
San Juan Regional Medical Center Inc Current Accepting new patients

Locations

801 W Maple St
Farmington, NM 87401
Phone (505) 325-5011

735 W Animas St
Farmington, NM 87401
Phone (505) 564-6850

407 S Schwartz Ave
Ste 201
Farmington, NM 87401
Phone (505) 609-6300

630 W Maple St
Farmington, NM 87401
Phone (505) 325-1123

4820 E Main St
Ste 2
Farmington, NM 87402
Phone (505) 609-6610

Organizations & group practices 7

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": "1451520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468972800000",
    "number": "1891150108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6210",
            "city": "FARMINGTON",
            "state": "NM",
            "postal_code": "874996210",
            "telephone_number": "505-609-2258",
            "fax_number": "505-609-2259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "630 W MAPLE ST",
            "city": "FARMINGTON",
            "state": "NM",
            "postal_code": "874016113",
            "telephone_number": "505-609-6300",
            "fax_number": "505-609-6301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANKENAU",
        "first_name": "ERICA",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-12-31",
        "last_updated": "2016-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NM",
            "license": "1130229",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NM",
            "license": "PA2015-0082",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmington, NM

Sources for this page

Verify at the official NPI Registry.