Individual provider Active NPI

Melanie Gantner, PA

  • Medical Physician Assistant
  • Las Cruces, NM
National Provider Identifier
1912952003
Registry record updated Oct 5, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA2004-0012 Issued in NM
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

Updated by the provider on Oct 5, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041120000000 NM Practitioner - Physician Assistant 3971568841 Reassigns benefits to 1 organization

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
Health Care Solutions PAGroup PAC ID 7315836574, 13 clinicians

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 Home health agency, Las Cruces, NM, CCN 327208
  • Sierra Home Care Home health agency, Las Cruces, NM, CCN 327180
  • Memorial Medical Center Hospital, Las Cruces, NM, CCN 320018
  • Three Crosses Regional Hospital LLC Hospital, Las Cruces, NM, CCN 320091
  • Mountain View Regional Medical Center Hospital, Las Cruces, NM, CCN 320085

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA2004-0012NMMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew 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.

Hospital & facility affiliations 5

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": "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

Verify at the official NPI Registry.