LISA ANNE ETHRIDGE
NPI 1467005140
Nurse Practitioner - Family in Albuquerque, NM

Q: What is Lisa Ethridge's NPI number?

The NPI number for Lisa Ethridge is 1467005140. It was assigned to this individual provider in the NPPES registry on July 22, 2019.

Q: What is Lisa Ethridge's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Q: When was this NPI record last updated?

The NPPES record for Lisa Ethridge was last updated on December 28, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.

Active since July 22, 2019PECOS EnrolledAccepts Medicare Assignment

93.21/100

CMS Quality Rating

1625 RIO BRAVO BLVD SW STE 36, ALBUQUERQUE, NM 87105(505) 777-3004 Get Directions Write a Review

NPPES record last updated: December 28, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Dec 28, 2022, Nov 19, 2019, Jul 22, 2019 (3 updates tracked since 2019).

On this page

About Lisa Anne Ethridge NPPES

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

LISA ANNE ETHRIDGE (NPI 1467005140) is an individual family provider in Albuquerque, New Mexico, licensed in New Mexico (57020) and active in the NPI registry since July 2019. She is enrolled in Medicare PECOS, is affiliated with Christus St Vincent Regional Medical Center, and maintains a secondary practice location in Los Lunas.

NPPES Registry Identity

NPI1467005140

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NameLISA ANNE ETHRIDGE

Location Address1625 RIO BRAVO BLVD SW STE 36Albuquerque, NM 87105-6060

Mailing AddressPo Box 740018Atlanta, GA 30374-0018 · (773) 759-7550 · Fax (312) 929-0373

Phone(505) 777-3004

Sole ProprietorNo

Medical School CMSOtherGraduated 2019

Enumeration DateJuly 22, 2019

Last NPPES UpdateDecember 28, 20223 updates tracked since enumeration

NPPES CertifiedDecember 28, 2022

✔ NPI 1467005140 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

License✔ Licensed in NM · 57020

1625 RIO BRAVO BLVD SW STE 36, Albuquerque, NM 87105

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Secondary Practice Location 1

Location 1328 Main St NELos Lunas, NM 87031-7454 · Phone (505) 916-5446

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health, Ambetter from Superior HealthPlan, Ambetter of Oklahoma.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Lisa Anne Ethridge 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.

PECOS PAC ID2062744428

PECOS Enrollment IDI20191105000140

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.

Areas of Expertise CMS Part B claims 4

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.

84 services46 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.

33 services27 patients

Insertion of needle into vein for collection of blood sample 36415

This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.

20 services17 patients

Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional 99211

This service involves an outpatient visit for established patients who may not need direct interaction with a healthcare professional. It could include reviewing test results, monitoring existing conditions, or adjusting treatment plans. It's typically done remotely, ensuring your comfort and convenience.

14 services12 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Christus St Vincent Regional Medical Center

Acute Care Hospitals · Santa Fe, NM

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number320002

Location455 St Michael's DriveSanta Fe, NM 87505 · Santa Fe County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 87105 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.

93.21/100

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

Scored through an Alternative Payment Model

Quality

86.43

Promoting Interoperability

100

Improvement Activities

Other Providers at the Same Location NPPES 5

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

JUAN SEBASTIAN SOCHE

Family Medicine