MR. ETHAN BLACKNEY-LOPEZ AG-ACNP
NPI 1619697570
Nurse Practitioner - Acute Care in Albuquerque, NM

Active since August 31, 2022PECOS EnrolledAccepts Medicare Assignment
93.54/100
CMS Quality Rating
2211 LOMAS BLVD NE, ALBUQUERQUE, NM 87106(505) 272-2711 Get Directions Write a Review

NPPES record last updated: May 26, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: May 26, 2023, Aug 31, 2022 (2 updates tracked since 2022).

About Mr. Ethan Blackney-lopez Ag-acnp NPPES

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

MR. ETHAN BLACKNEY-LOPEZ AG-ACNP (NPI 1619697570) is an individual acute care provider in Albuquerque, New Mexico, licensed in New Mexico (69604) and active in the NPI registry since August 2022. He is enrolled in Medicare PECOS, is affiliated with Unm Hospital, and is a graduate of University Of New Mexico School Of Medicine (2022).

NPPES Registry Identity

NPI1619697570
Entity TypeIndividualMale
Primary Taxonomy363LA2100X
Provider Legal NameMR. ETHAN BLACKNEY-LOPEZCredential: AG-ACNP
Location Address2211 LOMAS BLVD NEAlbuquerque, NM 87106-2719
Mailing Address9 Sena DrLos Lunas, NM 87031-6948 · (505) 507-3987
Sole ProprietorNo
Medical School CMSUniversity Of New Mexico School Of MedicineGraduated 2022
Enumeration DateAugust 31, 2022
Last NPPES UpdateMay 26, 20232 updates tracked since enumeration
NPPES CertifiedMay 26, 2023
NPI 1619697570 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyNurse Practitioner · Acute CarePhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LA2100X
License Licensed in NM · 69604
2211 LOMAS BLVD NE, Albuquerque, NM 87106

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

Mr. Ethan Blackney-lopez Ag-acnp 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 ID6901273531
PECOS Enrollment IDI20221110000814
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 3

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.

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.
112 services44 patients
Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, 20 minutes or more 99308
A follow-up nursing facility visit per day is a daily check-up service provided by healthcare professionals. It lasts around 15 minutes and involves assessing your health status, monitoring your recovery progress, and addressing any concerns you may have about your health or treatment.
57 services14 patients
Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 10 minutes 99307
A follow-up nursing facility visit per day typically lasts about 10 minutes. This service involves a healthcare professional checking on your health status, answering any questions you may have, and monitoring your progress. This routine check ensures your recovery is on track and any concerns are addressed promptly.
35 services13 patients

Hospital Affiliations CMS Care Compare

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

Unm Hospital

Acute Care Hospitals · Albuquerque, NM
2/5 CMS rating
OwnershipGovernment - State
CMS Certification Number320001
Location2211 Lomas Boulevard NEAlbuquerque, NM 87106 · Bernalillo County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 87106 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.

93.54/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality93.21
Promoting Interoperability100
Improvement Activities40
Cost63.83

Other Providers at the Same Location NPPES 20

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

Pathology (Anatomic Pathology & Clinical Pathology)
2211 LOMAS BLVD NE
ALBUQUERQUE, NM 87106
Obstetrics & Gynecology
2211 LOMAS BLVD NE
ALBUQUERQUE, NM 87106
Audiologist
2211 LOMAS BLVD NE
ALBUQUERQUE, NM 87106
Student in an Organized Health Care Education/Training Program
2211 LOMAS BLVD NE
ALBUQUERQUE, NM 87106
Advanced Practice Midwife
2211 LOMAS BLVD NE, 4TH FLOOR AMBULATORY CARE CTR
ALBUQUERQUE, NM 87106
Radiology (Diagnostic Radiology)
2211 LOMAS BLVD NE
ALBUQUERQUE, NM 87106
Pediatrics
2211 LOMAS BLVD NE
ALBUQUERQUE, NM 87106
Pathology (Clinical Pathology/Laboratory Medicine)
2211 LOMAS BLVD NE
ALBUQUERQUE, NM 87106

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 Ethan Blackney-lopez's NPI number?

The NPI number for Ethan Blackney-lopez is 1619697570. It was assigned to this individual provider in the NPPES registry on August 31, 2022.

Where is Ethan Blackney-lopez located?

Ethan Blackney-lopez practices at 2211 Lomas Blvd NE, Albuquerque, NM 87106. The listed phone number is (505) 272-2711.

What is Ethan Blackney-lopez's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Acute Care, with taxonomy code 363LA2100X.

Is Ethan Blackney-lopez enrolled in Medicare?

Yes. Ethan Blackney-lopez 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 Ethan Blackney-lopez affiliated with any hospitals?

According to CMS data, Ethan Blackney-lopez is affiliated with Unm Hospital.

When was this NPI record last updated?

The NPPES record for Ethan Blackney-lopez was last updated on May 26, 2023. 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.