DR. AMANDA BUSTAMANTE PROVENCIO MD
NPI 1558855650
Family Medicine in Las Cruces, NM

Q: What is Amanda Provencio's NPI number?

The NPI number for Amanda Provencio is 1558855650. It was assigned to this individual provider in the NPPES registry on June 21, 2018.

Q: What is Amanda Provencio's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Q: When was this NPI record last updated?

The NPPES record for Amanda Provencio was last updated on August 25, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 months 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 June 21, 2018PECOS EnrolledAccepts Medicare Assignment

1240 S TELSHOR BLVD STE A, LAS CRUCES, NM 88011(575) 259-3638(855) 538-0781 Get Directions Write a Review

NPPES record last updated: August 25, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Aug 15, 2025, May 5, 2025, Jun 21, 2018 (3 updates tracked since 2018).

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About Dr. Amanda Bustamante Provencio Md NPPES

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

DR. AMANDA BUSTAMANTE PROVENCIO MD (NPI 1558855650) is an individual family medicine provider in Las Cruces, New Mexico, licensed in New Mexico (RS2018-0570) and active in the NPI registry since June 2018. She is enrolled in Medicare PECOS, is affiliated with Memorial Medical Center, and is a graduate of University Of New Mexico School Of Medicine (2018).

NPPES Registry Identity

NPI1558855650

Entity TypeIndividualFemale

Primary Taxonomy207Q00000X

Provider Legal NameDR. AMANDA BUSTAMANTE PROVENCIOCredential: MD

Location Address1240 S TELSHOR BLVD STE ALas Cruces, NM 88011-4731

Mailing Address1240 S Telshor Blvd Ste ALas Cruces, NM 88011-4731 · (575) 259-3638 · Fax (855) 538-0781

Phone(575) 259-3638

Fax(855) 538-0781

Sole ProprietorNo

Medical School CMSUniversity Of New Mexico School Of MedicineGraduated 2018

Enumeration DateJune 21, 2018

Last NPPES UpdateAugust 25, 20253 updates tracked since enumeration

NPPES CertifiedAugust 25, 2025

✔ NPI 1558855650 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in NM · RS2018-0570

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

1240 S TELSHOR BLVD STE A, Las Cruces, NM 88011

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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

Dr. Amanda Bustamante Provencio Md 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 ID8729480488

PECOS Enrollment IDI20210719000098

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 6

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.

67 services50 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.

59 services52 patients

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232

Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.

50 services24 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.

45 services40 patients

Hospital discharge day management, 30 minutes or less 99238

Hospital discharge day management of 30 minutes or less includes finalizing your treatment, discussing your progress, and planning after-care at home. It ensures you're ready to leave the hospital and continue recovery safely.

21 services21 patients

Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223

Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.

18 services17 patients

Hospital Affiliations CMS Care Compare 3

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

Memorial Medical Center

Acute Care Hospitals · Las Cruces, NM

1/5 CMS rating

OwnershipProprietary

CMS Certification Number320018

Location2450 South Telshor BlvdLas Cruces, NM 88011 · Dona Ana County

Emergency services Birthing friendly

Artesia General Hospital

Acute Care Hospitals · Artesia, NM

OwnershipVoluntary non-profit - Other

CMS Certification Number320030

Location702 N 13th StreetArtesia, NM 88210 · Eddy County

Emergency services

Mountain View Regional Medical Center

Acute Care Hospitals · Las Cruces, NM

1/5 CMS rating

OwnershipProprietary

CMS Certification Number320085

Location4311 East Lohman AvenueLas Cruces, NM 88011 · Dona Ana County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 88011 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.

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.

MESILLA VALLEY PAIN CLINIC, LLC

Clinic/Center (Pain)