Active NPI
Melanie Gantner, PA
- Medical Physician Assistant
- Las Cruces, NM
National Provider Identifier
1912952003
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- PA2004-0012
- Practice address
- 540 Walton Blvd
Ste C
Las Cruces, NM 88001-8433 - Phone
- (575) 525-2700
- Fax
- (575) 524-2045
- NPI assigned
- May 24, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | PA2004-0012 | NM | Primary |
Addresses
Primary practice location
540 Walton Blvd
Ste C
Las Cruces, NM 88001-8433
Mailing address
540 Walton Blvd
Ste C
Las Cruces, NM 88001-8433
Phone (575) 525-2700
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2004
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
1680 Calle de Alvarez
Suite B
Las Cruces, NM 88005-3821
Phone (575) 524-3346
Hospital & facility affiliations
- Tender Care Home Health
- Sierra Home Care
- Memorial Medical Center
- Three Crosses Regional Hospital LLC
- Mountain View Regional Medical Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA2004-0012 | NM | MD | Medical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Familycare Associates,PA | Past | Accepting new patients |
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.
-
- Family Medicine Physician
- Ruidoso, NM
- NPI 1366410771
-
- Family Medicine Physician
- Las Cruces, NM
- NPI 1821161407
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Home Health Agency
- Las Cruces, NM
- NPI 1841436144
-
- General Acute Care Hospital
- Las Cruces, NM
- NPI 1205882503
-
- General Acute Care Hospital
- Las Cruces, NM
- NPI 1700821808
-
- Home Health Agency
- Truth Or Consequences, NM
- NPI 1184693665
-
- General Acute Care Hospital
- Las Cruces, NM
- NPI 1760020044
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148428800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1475625600000",
"number": "1912952003",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "540 WALTON BLVD",
"address_2": "STE C",
"city": "LAS CRUCES",
"state": "NM",
"postal_code": "880018433",
"telephone_number": "575-525-2700",
"fax_number": "575-524-2045"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "540 WALTON BLVD",
"address_2": "STE C",
"city": "LAS CRUCES",
"state": "NM",
"postal_code": "880018433",
"telephone_number": "575-525-2700",
"fax_number": "575-524-2045"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GANTNER",
"first_name": "MELANIE",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-05-24",
"last_updated": "2016-10-05",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "NM",
"license": "PA2004-0012",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Las Cruces, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2016; 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.