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DEVEN WALLER
NPI 1750165205
Physician Assistant in Albuquerque, NM

Active since August 23, 2023PECOS EnrolledAccepts Medicare Assignment
1500 N RENAISSANCE BLVD NE STE C, ALBUQUERQUE, NM 87107(505) 266-5565 Get Directions Write a Review

NPPES record last updated: September 3, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Sep 3, 2025, Aug 23, 2023 (2 updates tracked since 2023).

About Deven Waller NPPES

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

DEVEN WALLER (NPI 1750165205) is an individual physician assistant in Albuquerque, New Mexico and active in the NPI registry since August 2023. She is enrolled in Medicare PECOS and is a graduate of Other (2025).

NPPES Registry Identity

NPI1750165205
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameDEVEN WALLER
Location Address1500 N RENAISSANCE BLVD NE STE CAlbuquerque, NM 87107-7002
Mailing Address1500 N Renaissance Blvd Ne Ste CAlbuquerque, NM 87107-7002 · (505) 266-5565
Phone(505) 266-5565
Sole ProprietorNo
Medical School CMSOtherGraduated 2025
Enumeration DateAugust 23, 2023
Last NPPES UpdateSeptember 3, 20252 updates tracked since enumeration
NPPES CertifiedSeptember 3, 2025
✔ NPI 1750165205 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
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.
1500 N RENAISSANCE BLVD NE STE C, Albuquerque, NM 87107
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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

Deven Waller 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 ID1355839549
PECOS Enrollment IDI20251021000634
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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 87107 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.

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.

CHRISTIAN SALAZAR
Physician Assistant
1500 N RENAISSANCE BLVD NE STE C
ALBUQUERQUE, NM 87107
Bernalillo County (505) 266-5565
MILLIE ANN ZACHARIAH
Physician Assistant
1500 N RENAISSANCE BLVD NE STE C
ALBUQUERQUE, NM 87107
Bernalillo County (505) 266-5565
ANGELICA E POUND-ESPERICUETA PA-C
Physician Assistant
1500 N RENAISSANCE BLVD NE STE C
ALBUQUERQUE, NM 87107
Bernalillo County (505) 266-5565
EZEQUIEL CHAVEZ
Orthopaedic Surgery
1500 N RENAISSANCE BLVD NE STE C
ALBUQUERQUE, NM 87107
Bernalillo County (505) 266-5565
ERHIGA EKHAMA
Student in an Organized Health Care Education/Training Program
1500 N RENAISSANCE BLVD NE STE C
ALBUQUERQUE, NM 87107
Bernalillo County (505) 266-5565
BIRTI KAUR SINGH
Physician Assistant
1500 N RENAISSANCE BLVD NE STE C
ALBUQUERQUE, NM 87107
Bernalillo County (505) 266-5565
SONYA MICHELLE LOPEZ PA-S
Student in an Organized Health Care Education/Training Program
1500 N RENAISSANCE BLVD NE STE C
ALBUQUERQUE, NM 87107
Bernalillo County (505) 266-5565
MEGHAN REEVES
Physician Assistant
1500 N RENAISSANCE BLVD NE STE C
ALBUQUERQUE, NM 87107
Bernalillo County (505) 266-5565

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 Deven Waller's NPI number?

The NPI number for Deven Waller is 1750165205. It was assigned to this individual provider in the NPPES registry on August 23, 2023.

Where is Deven Waller located?

Deven Waller practices at 1500 N Renaissance Blvd NE Ste C, Albuquerque, NM 87107. The listed phone number is (505) 266-5565.

What is Deven Waller's specialty?

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

Is Deven Waller enrolled in Medicare?

Yes. Deven Waller 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.

When was this NPI record last updated?

The NPPES record for Deven Waller was last updated on September 3, 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.