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ANDREW THOMAS THEUS PA-C
NPI 1568029239
Physician Assistant in Estancia, NM

Active since May 28, 2019PECOS EnrolledAccepts Medicare Assignment
83.84/100
CMS Quality Rating
903 5TH ST # C, ESTANCIA, NM 87016(505) 384-2777 Get Directions Write a Review

NPPES record last updated: July 16, 2019. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jul 16, 2019, May 28, 2019 (2 updates tracked since 2019).

About Andrew Thomas Theus Pa-c NPPES

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

ANDREW THOMAS THEUS PA-C (NPI 1568029239) is an individual physician assistant in Estancia, New Mexico, licensed in New Mexico (PA2019-0052) and active in the NPI registry since May 2019. He is enrolled in Medicare PECOS, is affiliated with Presbyterian Hospital, and is a graduate of Other (2019).

NPPES Registry Identity

NPI1568029239
Entity TypeIndividualMale
Primary Taxonomy363A00000X
Provider Legal NameANDREW THOMAS THEUSCredential: PA-C
Location Address903 5TH ST # CEstancia, NM 87016-1155
Mailing AddressPo Box 305Edgewood, NM 87015-0305 · (706) 575-8004
Phone(505) 384-2777
Sole ProprietorNo
Medical School CMSOtherGraduated 2019
Enumeration DateMay 28, 2019
Last NPPES UpdateJuly 16, 20192 updates tracked since enumeration
✔ NPI 1568029239 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in NM · PA2019-0052
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
903 5TH ST # C, Estancia, NM 87016
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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

Andrew Thomas Theus Pa-c 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 ID1153658562
PECOS Enrollment IDI20190808000217
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 services58 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.
65 services60 patients
New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203
This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.
46 services46 patients
Telephone, internet, or electronic health record assessment and management with written report by consulting physician, at least 5 minutes 99451
This service involves a consulting physician assessing your health condition via a phone or internet interaction. The doctor will spend at least 5 minutes discussing your health concerns. Afterwards, a written report summarizing the findings and recommendations will be provided for your reference.
28 services28 patients
Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215
This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.
21 services19 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
15 services15 patients

Hospital Affiliations CMS Care Compare

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

Presbyterian Hospital

Acute Care Hospitals · Albuquerque, NM
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number320021
Location1100 Central Avenue SEAlbuquerque, NM 87106 · Bernalillo County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 87016 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
$68.00 typical visit price
range $17.00 – $135.35
Typical copayment $17.00 (range $4.25 – $33.83)
Most-billed visit code 99213
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.

83.84/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality84.59
Promoting Interoperability100
Improvement Activities40
Cost58.63

Referred Medical Equipment & Supplies CMS DME claims 2

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390
DME-Oxygen and Supplies · category DC002N
3 suppliers19 claims19 services$75.07 avg. paid by Medicare
Portable oxygen concentrator, rental E1392
DME-Oxygen and Supplies · category DC002N
2 suppliers12 claims12 services$35.65 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 2

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

ALYSON DEAKYNE LCSW
Social Worker (Clinical)
903 5TH ST # C
ESTANCIA, NM 87016
Torrance County (505) 384-2777
MR. KELLY L. MCDONALD PA
Physician Assistant
903 5TH ST # C
ESTANCIA, NM 87016
Torrance County (505) 384-2777

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 Andrew Theus's NPI number?

The NPI number for Andrew Theus is 1568029239. It was assigned to this individual provider in the NPPES registry on May 28, 2019.

Where is Andrew Theus located?

Andrew Theus practices at 903 5th St # C, Estancia, NM 87016. The listed phone number is (505) 384-2777.

What is Andrew Theus's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Andrew Theus enrolled in Medicare?

Yes. Andrew Theus 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.

Is Andrew Theus affiliated with any hospitals?

According to CMS data, Andrew Theus is affiliated with Presbyterian Hospital.

When was this NPI record last updated?

The NPPES record for Andrew Theus was last updated on July 16, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.