THERESA MARIE CASTLEMAIN RN, MSN, CNP
NPI 1083983605
Nurse Practitioner - Adult Health in Albuquerque, NM

Q: What is Theresa Castlemain's NPI number?

The NPI number for Theresa Castlemain is 1083983605. It was assigned to this individual provider in the NPPES registry on December 28, 2011.

Q: What is Theresa Castlemain's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Adult Health, with taxonomy code 363LA2200X.

Active since December 28, 2011PECOS Enrolled

79.36/100

CMS Quality Rating

7788 JEFFERSON ST NE, ALBUQUERQUE, NM 87109(505) 999-1600 Get Directions Write a Review

NPPES record last updated: December 28, 2011. Verified against the NPPES registry weekly; last sync: October 18, 2026.

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About Theresa Marie Castlemain Rn, Msn, Cnp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

THERESA MARIE CASTLEMAIN RN, MSN, CNP (NPI 1083983605) is an individual adult health provider in Albuquerque, New Mexico, licensed in New Mexico (CNP-01619) and active in the NPI registry since December 2011. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1083983605

Entity TypeIndividualFemale

Primary Taxonomy363LA2200X

Provider Legal NameTHERESA MARIE CASTLEMAINCredential: RN, MSN, CNP

Location Address7788 JEFFERSON ST NEAlbuquerque, NM 87109-4342

Mailing Address7788 Jefferson St NeAlbuquerque, NM 87109-4342 · (505) 999-1600

Phone(505) 999-1600

Sole ProprietorYes

Enumeration DateDecember 28, 2011

✔ NPI 1083983605 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Adult HealthPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LA2200X

License✔ Licensed in NM · CNP-01619

7788 JEFFERSON ST NE, Albuquerque, NM 87109

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Theresa Marie Castlemain Rn, Msn, Cnp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Theresa Castlemain reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Southwest Gastroenterology Associates

0.2 mi

Specialist

7788 JEFFERSON ST NE
Albuquerque, NM 87109

Reassigned Medicare billing, New Mexico enrollment
36 clinicians in this Medicare group

NPI 1902931728 (505) 999-1600

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 3

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

171 services166 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

72 services72 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

21 services21 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 87109 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$84.79 typical visit price

range $54.26 – $166.80

Typical copayment $21.19 (range $13.56 – $41.70)

Most-billed visit code 99203

Established Patient

$96.38 typical visit price

range $17.00 – $135.35

Typical copayment $24.09 (range $4.25 – $33.83)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

79.36/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Quality

80.35

Promoting Interoperability

100

Improvement Activities

Cost

50.85

Reported Quality Measures

Care Plan

Percentage of patients aged 65 years and older who have an advance care plan or surrogate decision maker documented in the medical record that an advance care plan was discussed but the patient did not wish or was not able to name a surrogate decision maker…

99%478 patients4/55-star benchmark: 100%

Documentation of Current Medications in the Medical Record

Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter.

100%1,491 patients5/55-star benchmark: 100%

e-Prescribing

At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.

96%789 patients4/55-star benchmark: 99%

Health Information Exchange

The MIPS eligible clinician that transitions or refers their patient to another setting of care or health care clinician (1) uses CEHRT to create a summary of care record; and (2) electronically transmits such summary to a receiving health care clinician for…

57%784 patients3/55-star benchmark: 88%

Medication Reconciliation

The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.

100%468 patients5/55-star benchmark: 100%

Patient-Specific Education

The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.

36%1,084 patients2/55-star benchmark: 97%

Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan

Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…

90%1,082 patients4/55-star benchmark: 97%

Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention

Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received tobacco cessation intervention if identified as a tobacco user

Patients screenedForUse: 100% · 594 patients

98%325 patients5/55-star benchmark: 98%

Preventive Care and Screening: Unhealthy Alcohol Use: Screening & Brief Counseling

Percentage of patients aged 18 years and older who were screened for unhealthy alcohol use using a systematic screening method at least once within the last 24 months AND who received brief counseling if identified as an unhealthy alcohol user

99%325 patients4/55-star benchmark: 100%

Provide Patient Access

At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…

78%1,084 patients4/55-star benchmark: 100%

Secure Messaging

For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure…

36%1,084 patients2/55-star benchmark: 89%

View, Download, or Transmit (VDT)

At least one patient seen by the MIPS eligible clinician during the performance period (or patient-authorized representative) views, downloads or transmits their health information to a third party during the performance period.

49%1,084 patients

Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

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