Andrew Jensen

Individual provider Active NPI Family Medicine Physician · Zuni, NM

NPI 1972921005 · NPPES record last updated Mar 4, 2019

Key facts

NPI
1972921005
Entity type
Individual (NPI type 1)
Primary specialty
Family Medicine Physician 207Q00000X
License
10447 (SD)
Practice address
12 B Ave
Zuni, NM 87327
Phone
(505) 782-4431
Fax
(505) 782-4502
NPI assigned
Apr 5, 2014
Sex
Male
Sole proprietor
No

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 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

Medicare Care Compare profile

Specialty
Family Practice
Education
Icahn School of Medicine at Mount Sinai, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Zuni Indian Hospital (48 clinicians)

Practice addresses (Care Compare)

Route 301 N 21 B St
Zuni, NM 87327-0467
Phone (505) 782-4431

Hospital & facility affiliations

  • Zuni Comprehensive Community Health Center Hospital · Zuni, NM · CCN 320060
  • Rehoboth McKinley Christian Health Care Services Hospital · Gallup, NM · CCN 321313

Merit-based Incentive Payment System (MIPS)

Final score
82.36 of 100 (group)
Quality
87.45
Improvement activities
0
Cost
93.44

Medicare participation

Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20170809000562 TX Practitioner - Family Practice 8022235233 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Zuni Indian Hospital Current
since Jul 18, 2017
Accepting new patients
Unm Medical Group Inc Past
since Jul 18, 2017
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 10447 SD Yes

Addresses

Primary practice location

12 B Ave
Zuni, NM 87327

Mailing address

1115 E 20TH St
Sioux Falls, SD 57105-1013

Other providers in Zuni, NM

All providers in Zuni, NM · Family Medicine Physician in New Mexico

Sources for this page

Verify at the official NPI Registry.