Albert E Crusco, DDS
Individual provider Active NPI General Practice Dentistry · Questa, NM
NPI 1962698282 · NPPES record last updated Mar 9, 2023
Key facts
- NPI
- 1962698282
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- BD22019 (NM)
- Practice address
- 2573 State Highway 522
Questa, NM 87556-8755 - Phone
- (575) 586-0331
- Fax
- (575) 586-0519
- NPI assigned
- Sep 20, 2007
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NM
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230314003147 | NM | Practitioner - Dentist | 8820462856 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D6092 | AZ | MD | General Practice Dentistry |
| BD22019 | NM | MD | General Practice Dentistry |
| 25095 | TX | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Presbyterian Medical Services | General Practice | Current |
Accepting new patients |
| Presbyterian Medical Services | Current | Accepting new patients | |
| Presbyterian Medical Services | Current |
Accepting new patients |
Locations
1422 Paseo de Peralta
Santa Fe, NM 87501
Phone (505) 982-5565
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 25095 | TX | |
| General Practice Dentistry | 1223G0001X | D6092 | AZ | |
| General Practice Dentistry | 1223G0001X | BD22019 | NM | Yes |
Addresses
Primary practice location
2573 State Highway 522
Questa, NM 87556-8755
Mailing address
2573 State Hwy. 522
Questa, NM 87556
Phone (575) 586-0331
Other providers in Questa, NM
- Bestcare Pharmacy 4 LLC
- Bright Rain Counseling LLC
- Garrett King Campbell
- Deborah Chavez
- Creo Therapy Studio LLC
- Cynthia Ann Ewers
- Isabel Florko
- Cherlon R Gano
- Jose Adrian Gonzalez
- Kristin L Graziano
All providers in Questa, NM · General Practice Dentistry in New Mexico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 9, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.