Dr Amanda Bustamante Provencio, MD in Las Cruces, NM

Dr Amanda Bustamante Provencio, MD is a medicare enrolled "Family Medicine" physician in Las Cruces, New Mexico. She went to University Of New Mexico School Of Medicine and graduated in 2018 and has 8 years of diverse experience with area of expertise as Family Practice. She is a member of the group practice Phc-las Cruces Inc, Northwest Hospital Medicine Physicians Llc and her current practice location is 1240 S Telshor Blvd Ste A, Las Cruces, New Mexico. You can reach out to her office (for appointments etc.) via phone at (575) 259-3638.

Dr Amanda Bustamante Provencio is licensed to practice in New Mexico (license number RS2018-0570) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1558855650.

Contact Information

	Dr Amanda Bustamante Provencio, MD
	1240 S Telshor Blvd Ste A, Las Cruces, NM 88011-4731
	(575) 259-3638
	(855) 538-0781

Map and Direction

Physician's Profile

Full Name	Dr Amanda Bustamante Provencio
Gender	Female
Speciality	Family Practice
Experience	8 Years
Location	1240 S Telshor Blvd Ste A, Las Cruces, New Mexico
Accepts Medicare Assignments	Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.

Medical Education and Training:

Dr Amanda Bustamante Provencio attended and graduated from University Of New Mexico School Of Medicine in 2018

NPI Data:

NPI Number: 1558855650
Provider Enumeration Date: 06/21/2018
Last Update Date: 08/25/2025

Medicare PECOS Information:

PECOS PAC ID: 8729480488
Enrollment ID: I20210719000098

Medical Identifiers

Medical identifiers for Dr Amanda Bustamante Provencio such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1558855650	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
207Q00000X	Family Medicine	RS2018-0570 (New Mexico)	Primary

Medical Facilities Affiliation

Facility Name	Location	Facility Type
Ambercare Home Health	Silver city, NM	Home health agency
Memorial Medical Center	Las cruces, NM	Hospital

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Phc-las Cruces Inc	4486635802	19
Northwest Hospital Medicine Physicians Llc	6406805449	49

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Amanda Bustamante Provencio allows following entities to bill medicare on her behalf.

Entity Name	Phc-las Cruces Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1164445136 PECOS PAC ID: 4486635802 Enrollment ID: O20040624000297

Entity Name	Northwest Hospital Medicine Physicians Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1972056752 PECOS PAC ID: 6406805449 Enrollment ID: O20170120001785

Entity Name	New Mexico Pac Services Pc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1801325634 PECOS PAC ID: 3072889211 Enrollment ID: O20171016003197

Entity Name	Nm Pacs 2 Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1366928749 PECOS PAC ID: 3375892060 Enrollment ID: O20180814000050

Entity Name	Cs Pacs 3 West Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1073378238 PECOS PAC ID: 8921546797 Enrollment ID: O20240813000386

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Amanda Bustamante Provencio is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Dr Amanda Bustamante Provencio, MD 1240 S Telshor Blvd Ste A, Las Cruces, NM 88011-4731 Ph: (575) 259-3638	Dr Amanda Bustamante Provencio, MD 1240 S Telshor Blvd Ste A, Las Cruces, NM 88011-4731 Ph: (575) 259-3638

Reviews and Comments

Family Medicine Doctors in Las Cruces, NM

Dr. Susan Diane Thomas, M.D. Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 2450 S Telshor Blvd, Las Cruces, NM 88011 Phone: 505-521-5381 Fax: 505-521-5376
Alaa Masjune, MD Family Medicine Medicare: Medicare Enrolled Practice Location: 2450 S Telshor Blvd, Las Cruces, NM 88011 Phone: 575-521-5385
Dr. Denise A. Leonardi, M.D. Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 1135 S Main St, Suite B, Las Cruces, NM 88005 Phone: 505-525-4000 Fax: 505-525-4050
Baldomero P Garcia, MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 3003 Hillrise Dr, Suite A, Las Cruces, NM 88011 Phone: 575-521-7550 Fax: 575-521-7617
Dr. Roset Samuel, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 4371 E Lohman Ave, Las Cruces, NM 88011 Phone: 575-532-8900 Fax: 575-532-8974
Imelda Citlali Toledo-neely, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 2701 Missouri Ave, Las Cruces, NM 88011 Phone: 575-800-7987 Fax: 575-800-5879
Kathleen Sue Hales, MD Family Medicine Medicare: Medicare Enrolled Practice Location: 390 Calle De Alegra, Las Cruces, NM 88005 Phone: 575-556-8200 Fax: 575-556-8180

Dr Amanda Bustamante Provencio, MD - Medicare Family Practice in Las Cruces, NM