MRS. JESSICA LUCILLA WYACO TSABETSAYE (NPI# 1316220478) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316220478 |
| Entity Type | Individual |
| Full Name | MRS. JESSICA LUCILLA WYACO TSABETSAYE |
| Credential | PA |
| Practice Address |
5901 Harper Dr Ne Pmg Urgent Care Albuquerque NM 87109-3587 |
| Mailing Address |
5712 Potentilla Ct Nw Albuquerque NM 87120-6240 |
| Practice Telephone | 5058238233 |
| Practice Fax Number | 5058238059 |
| Mailing Telephone | 5057200606 |
| Enumeration Date | 2011-09-26 |
| Last Update Date | 2015-02-05 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | PA2011-0034 | NM | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NM | 19778082 | 05 |
| Street Address |
5901 HARPER DR NE PMG URGENT CARE |
| City | ALBUQUERQUE |
| State | NM |
| Zip Code | 87109-3587 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427043561 | Megan Van Winkle | Family Medicine | 5901 Harper Dr Ne, Pmg Urgent Care, Albuquerque, NM 87109-3587 | 2005-09-14 |
| 1023661311 | Kelly Jamison | Nurse Practitioner | 5901 Harper Dr Ne, Albuquerque, NM 87109-3587 | 2019-07-17 |
| 1023586898 | Sherrie Dugas | Nurse Practitioner | 5901 Harper Dr Ne, Albuquerque, NM 87109-3587 | 2018-11-08 |
| 1396210696 | Heather Rene Alter | Nurse Practitioner | 5901 Harper Dr Ne, Albuquerque, NM 87109-3587 | 2018-10-12 |
| 1114408754 | Mary Terese Anenkeng Anangfac | Nurse Practitioner | 5901 Harper Dr Ne, Albuquerque, NM 87109-3587 | 2018-08-22 |
| 1104311869 | John Luna | Physician Assistant | 5901 Harper Dr Ne, Albuquerque, NM 87109-3587 | 2018-06-26 |
| 1831687110 | Jason Mechenbier | Nurse Practitioner | 5901 Harper Dr Ne, Albuquerque, NM 87109 | 2018-04-23 |
| 1154835668 | Carol Beadle | Nurse Practitioner | 5901 Harper Dr Ne, Albuquerque, NM 87109-3587 | 2017-11-20 |
| 1235641838 | Kimberlee Elizabeth Tafoya | Nurse Practitioner | 5901 Harper Dr Ne, Albuquerque, NM 87109-3587 | 2017-11-04 |
| 1073035689 | Alexandra Carter | Physician Assistant | 5901 Harper Dr Ne, Albuquerque, NM 87109-3587 | 2017-07-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386286367 | Mikaela Epaloose | Behavior Technician | 100 Sun Avenue N.e., Suite 650, Albuquerque, NM 87109 | 2019-10-11 |
| 1245872464 | Marsha Director | Behavior Technician | 100 Sun Avenue Ne, Ste 650, Albuquerque, NM 87109 | 2019-10-09 |
| 1720637499 | Nancy Gail Vice | Technician | 7319 Laguna Niguel Drive Ne, Albuquerque, NM 87109 | 2019-09-05 |
| 1598314411 | Chau Vu | Behavior Technician | Attn: Behavioral Health Works 100 Sun Avenue N.e., Suite 650, Albuquerque, NM 87109 | 2019-09-04 |
| 1932753498 | Noelle Nielsen | Behavior Technician | 6401 Academy Rd. Ne Apt. 189, Albuquerque, NM 87109 | 2019-08-01 |
| 1952967952 | Caridad Merkel | Obstetrics & Gynecology | 6100 Pan American Fwy Ne Suite 450, Albuquerque, NM 87109 | 2019-05-15 |
| 1043795149 | Margaret Mcconville | Physical Therapist | Lovelace Women's Hospital Outpatient Rehabilitation, 4600 Montgomery Blvd Ne, Albuquerque, NM 87109 | 2018-09-25 |
| 1922586262 | Clark Endodontics LLC | Dentist | 7520 Montgomery Blvd Ne Bldg E1, Albuquerque, NM 87109 | 2018-07-30 |
| 1447736202 | Melissa Christine Scott | Registered Nurse | Lovelace Women's Hospital, 4701 Montgomery Blvd Ne, Albuquerque, NM 87109 | 2018-07-16 |
| 1508351990 | Gianna Nicole Casarez-quintana | Dentist | 7520 Montgomery Blvd Ne Bldg E10, Albuquerque, NM 87109 | 2018-06-27 |
| Find all providers in zip 87109 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609474550 | Mara Swartzentruber | Physician Assistant | 3310 Linda Vista Ave Se, Albuquerque, NM 87106-1514 | 2020-10-13 |
| 1336757301 | Dailey Doss | Physician Assistant | Raymond G. Murphy Va Medical Center, 1501 San Pedro Se, Albuquerque, NM 87108 | 2020-07-16 |
| 1487287413 | Thomas Clise | Physician Assistant | 629 San Pablo St Ne, Albuquerque, NM 87108-2137 | 2020-02-18 |
| 1912547324 | Kathleen Joyce L'heureux | Physician Assistant | 8124 Ventana Cielo Ave Nw, Albuquerque, NM 87114-5988 | 2020-01-14 |
| 1265097869 | Amber Zoubovitch | Physician Assistant | 7200 Montgomery Blvd Ne Ste 7121, Albuquerque, NM 87109-1510 | 2019-05-08 |
| 1639680739 | Wesley A Parker | Physician Assistant | 3777 Mdg, 2050a Second Street Se, Albuquerque, NM 87117-5522 | 2017-10-16 |
| 1003327487 | Elise Nicole Pedigo | Physician Assistant | 4700 Jefferson St Ne Ste 700, Albuquerque, NM 87109-2132 | 2017-10-12 |
| 1194170605 | Anna Marie Siow | Physician Assistant | 1014 Hummingbird Pl Sw, Albuquerque, NM 87105-8130 | 2016-05-03 |
| 1285032367 | Travis Householder | Physician Assistant | 201 Cedar St Se Ste 4610, Presbyterian Heart Group, Albuquerque, NM 87106-4936 | 2014-12-05 |
| 1508276973 | Stephanie Gonzales | Physician Assistant | 12241 Academy Rd Ne Ste 204, Albuquerque, NM 87111 | 2014-05-06 |
| Find all providers in ALBUQUERQUE | ||||
| City | ALBUQUERQUE |
| Zip Code | 87109 |
Please comment or provide details below to improve the information on MRS. JESSICA LUCILLA WYACO TSABETSAYE.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.