Individual provider Active NPI

Michelle Dean, CNP

  • Family Nurse Practitioner
  • Tucumcari, NM
National Provider Identifier
1932701372
Registry record updated Feb 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
60358 Issued in NM
Practice address
1302 E Main St
Tucumcari, NM 88401-2508
Phone
(575) 461-2200
NPI assigned
Nov 11, 2020
Last updated
Feb 10, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 10, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 60358 NM Primary

Addresses

Primary practice location

1302 E Main St
Tucumcari, NM 88401-2508

Mailing address

2200 W University Dr
Portales, NM 88130-9345
Phone (505) 264-2352

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
I20210224001022 NM Practitioner - Nurse Practitioner 2466867478 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Clovis Family Urgent Care LLCGroup PAC ID 4284095324, 9 clinicians
Presbyterian Healthcare ServicesGroup PAC ID 9234041708, 1,390 clinicians

Practice addresses (Care Compare)

2301 N Dr Martin Luther King Jr Blvd
Clovis, NM 88101-9401
Phone (575) 762-4455

2421 W 21St St
Suite B
Clovis, NM 88101-2006
Phone (575) 769-7577

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner, Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Presbyterian Healthcare Services Family Medicine CurrentSince Aug 26, 2024 Accepting new patients
Presbyterian Healthcare Services CurrentSince Aug 26, 2024 Accepting new patients
Presbyterian Medical Services CurrentSince Mar 8, 2021 Accepting new patients
Presbyterian Medical Services CurrentSince Mar 8, 2021 Accepting new patients
Presbyterian Medical Services Current Accepting new patients
Presbyterian Healthcare Services Past Accepting new patients
Presbyterian Medical Services Family Medicine Past Accepting new patients

Locations

4588 Paradise Blvd NW
Albuquerque, NM 87114
Phone (505) 923-2070

2200 W 21st St
Clovis, NM 88101
Phone (505) 769-7577

2421 W 21st St
Ste B
Clovis, NM 88101
Phone (575) 742-7824

1422 Paseo de Peralta
Santa Fe, NM 87501
Phone (505) 982-5565

1302 E Main St
Tucumcari, NM 88401
Phone (575) 461-2200

Interoperability endpoints

  • Direct secure messaging: mdean200945@direct.phs.org
  • Direct secure messaging: michelle.dean.p1@direct.pmsnm.nextgenshare.com

Organizations & group practices 8

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.

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": "1605052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612915200000",
    "number": "1932701372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 W UNIVERSITY DR",
            "city": "PORTALES",
            "state": "NM",
            "postal_code": "881309345",
            "telephone_number": "505-264-2352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1302 E MAIN ST",
            "city": "TUCUMCARI",
            "state": "NM",
            "postal_code": "884012508",
            "telephone_number": "575-461-2200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEAN",
        "first_name": "MICHELLE",
        "credential": "CNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-11-11",
        "last_updated": "2021-02-10",
        "certification_date": "2021-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NM",
            "license": "60358",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucumcari, NM

Sources for this page

Verify at the official NPI Registry.