LISA ANNE ETHRIDGE
NPI 1467005140
Nurse Practitioner - Family in Albuquerque, NM
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
Specialties & Licenses
Secondary Practice Location 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
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.
Medicare Billing Reassignments
3Medicare enrollment records show Lisa Ethridge reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Albuquerque, NM 87106
- Reassigned Medicare billing, New Mexico enrollment
- 2,331 clinicians in this Medicare group
Albuquerque, NM 87109
- Reassigned Medicare billing, New Mexico enrollment
- 399 clinicians in this Medicare group
Santa Fe, NM 87505
- Reassigned Medicare billing, New Mexico enrollment
- 31 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 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.
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, NMPhysician 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.
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.
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.
ALBUQUERQUE, NM 87105
ALBUQUERQUE, NM 87105
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 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.
Where is Lisa Ethridge located?
Lisa Ethridge practices at 1625 Rio Bravo Blvd SW Ste 36, Albuquerque, NM 87105. The listed phone number is (505) 777-3004.
What is Lisa Ethridge's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is Lisa Ethridge enrolled in Medicare?
Yes. Lisa Ethridge 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 organizations bill Medicare for Lisa Ethridge's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Lisa Ethridge reassigns Medicare benefits to 3 organizations: Presbyterian Healthcare Services (Albuquerque, NM), St Vincent Hospital (Albuquerque, NM) and Newmexidoc, PA. (Santa Fe, NM). Each 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 Lisa Ethridge's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
Is Lisa Ethridge affiliated with any hospitals?
According to CMS data, Lisa Ethridge is affiliated with Christus St Vincent Regional Medical Center.
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.
# Lisa Anne Ethridge · NPI 1467005140
Family physician in Albuquerque, New Mexico. Individual provider, active in the CMS NPPES registry since July 22, 2019.
## Identity
- **NPI:** 1467005140 (Entity type: Individual)
- **Enumerated:** July 22, 2019
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **State license:** 57020 (New Mexico)
- **Sole proprietor:** No
## Practice location
- **Address:** 1625 RIO BRAVO BLVD SW STE 36, Albuquerque, NM 87105-6060
- **Phone:** (505) 777-3004
## 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:** 3 organizations under Medicare reassignment (form CMS-855R): Presbyterian Healthcare Services (NPI 1215913470, Albuquerque, NM); St Vincent Hospital (NPI 1184558363, Albuquerque, NM); Newmexidoc, PA. (NPI 1316358989, Santa Fe, NM) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2019
## Record status
- **NPPES last updated:** December 28, 2022
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Source: [NPI Profile](https://npiprofile.com/npi/1467005140) · Data from the CMS NPPES public registry.