MRS. JOHANNA CHRISTINE PETTREY FNP-BC
NPI 1265413447
Nurse Practitioner - Family in Portales, NM
About Mrs. Johanna Christine Pettrey Fnp-bc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MRS. JOHANNA CHRISTINE PETTREY FNP-BC (NPI 1265413447) is an individual family provider in Portales, New Mexico, licensed in New Mexico (CNP01151) and active in the NPI registry since November 2005. She is enrolled in Medicare PECOS, is affiliated with Plains Regional Medical Center, and is a graduate of Other (2000).
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 1
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Mrs. Johanna Christine Pettrey Fnp-bc is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignment
Medicare enrollment records show Johanna Pettrey reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Portales, NM 88130
- Reassigned Medicare billing, New Mexico enrollment
- 16 clinicians in this Medicare group
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 2
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.
Hospital Affiliations CMS Care Compare 2
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Plains Regional Medical Center
Acute Care Hospitals · Clovis, NMRoosevelt General Hospital
Acute Care Hospitals · Portales, NMPhysician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 88130 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Referred Medical Equipment & Supplies CMS DME claims
Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.
Other Providers at the Same Location NPPES 10
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
PORTALES, NM 88130
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Johanna Pettrey's NPI number?
The NPI number for Johanna Pettrey is 1265413447. It was assigned to this individual provider in the NPPES registry on November 7, 2005.
Where is Johanna Pettrey located?
Johanna Pettrey practices at 1515 W Fir St, Portales, NM 88130. The listed phone number is (575) 356-6695.
What is Johanna Pettrey's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is Johanna Pettrey enrolled in Medicare?
Yes. Johanna Pettrey is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organization bills Medicare for Johanna Pettrey's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Johanna Pettrey reassigns Medicare benefits to La Casa De Buena Salud Inc. (Portales, NM). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Johanna Pettrey's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
Is Johanna Pettrey affiliated with any hospitals?
According to CMS data, Johanna Pettrey is affiliated with Plains Regional Medical Center and Roosevelt General Hospital.
When was this NPI record last updated?
The NPPES record for Johanna Pettrey was last updated on April 24, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Mrs. Johanna Christine Pettrey, FNP-BC · NPI 1265413447
Family physician in Portales, New Mexico. Individual provider, active in the CMS NPPES registry since November 7, 2005.
## Identity
- **NPI:** 1265413447 (Entity type: Individual)
- **Enumerated:** November 7, 2005
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **State license:** CNP01151 (New Mexico)
- **Sole proprietor:** No
## Practice location
- **Address:** 1515 W FIR ST, Portales, NM 88130-5703
- **Phone:** (575) 356-6695
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** La Casa De Buena Salud Inc. (NPI 1972603165, Portales, NM), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2000
## Record status
- **NPPES last updated:** April 24, 2024
- **Other identifiers:** Medicaid G7157 (NM)
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Source: [NPI Profile](https://npiprofile.com/npi/1265413447) · Data from the CMS NPPES public registry.