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ERIC LEE TIDWELL
NPI 1508506205
Student in an Organized Health Care Education/Training Program in Albuquerque, NM

Active since March 30, 2022PECOS Enrolled
5530 1 UNIVERSITY OF NEW MEXICO, ALBUQUERQUE, NM 87131(505) 272-2269(505) 272-5821 Get Directions Write a Review

NPPES record last updated: May 3, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: May 3, 2024, Apr 20, 2024, Nov 22, 2023 (3 updates tracked since 2023).

About Eric Lee Tidwell NPPES

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

ERIC LEE TIDWELL (NPI 1508506205) is an individual student in an organized health care education/training program in Albuquerque, New Mexico and active in the NPI registry since March 2022. He is enrolled in Medicare PECOS and maintains a secondary practice location in Searcy.

NPPES Registry Identity

NPI1508506205
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameERIC LEE TIDWELL
Location Address5530 1 UNIVERSITY OF NEW MEXICOAlbuquerque, NM 87131-0001
Mailing Address1 University Of New MexicoAlbuquerque, NM 87131-0001 · (505) 272-2269
Phone(505) 272-2269
Fax(505) 272-5821
Sole ProprietorYes
Enumeration DateMarch 30, 2022
Last NPPES UpdateMay 3, 20243 updates tracked since enumeration
NPPES CertifiedMay 3, 2024
✔ NPI 1508506205 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
Also ListedGeneral PracticeTaxonomy 208D00000X · License 010737 (AZ)
5530 1 UNIVERSITY OF NEW MEXICO, Albuquerque, NM 87131
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Secondary Practice Location 1

Location 13214 E Race AveSearcy, AR 72143-4810 · Phone (501) 350-1548

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Eric Lee Tidwell 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.

Other Providers at the Same Location NPPES

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

VERONICA MARLENE AMESQUITA CNP
Nurse Practitioner
5530 1 UNIVERSITY OF NEW MEXICO
ALBUQUERQUE, NM 87131
Bernalillo County (505) 272-0010

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 Eric Tidwell's NPI number?

The NPI number for Eric Tidwell is 1508506205. It was assigned to this individual provider in the NPPES registry on March 30, 2022.

Where is Eric Tidwell located?

Eric Tidwell practices at 5530 1 University Of New Mexico, Albuquerque, NM 87131. The listed phone number is (505) 272-2269.

What is Eric Tidwell's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Eric Tidwell enrolled in Medicare?

Yes. Eric Tidwell is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Eric Tidwell was last updated on May 3, 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.