Dr Desiree Renee Provencio, DNP, CNP, PMHNP-BC in Albuquerque, NM

Dr Desiree Renee Provencio, DNP, CNP, PMHNP-BC is a medicare enrolled "Nurse Practitioner - Psychiatric/mental Health" in Albuquerque, New Mexico. She graduated from nursing school in 2017 and has 7 years of diverse experience with area of expertise as Nurse Practitioner. Her current practice location is 6300 Riverside Plaza Ln Nw Ste 100, Albuquerque, New Mexico. You can reach out to her office (for appointments etc.) via phone at (505) 225-3110.

Dr Desiree Renee Provencio is licensed to practice in New Mexico (license number CNP-03491) 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 1336648328.

Contact Information

	Dr Desiree Renee Provencio, DNP, CNP, PMHNP-BC
	6300 Riverside Plaza Ln Nw Ste 100, Albuquerque, NM 87120-1908
	(505) 225-3110
	(505) 207-7988

Map and Direction

Provider's Profile

Full Name	Dr Desiree Renee Provencio
Gender	Female
Speciality	Nurse Practitioner
Experience	7 Years
Location	6300 Riverside Plaza Ln Nw Ste 100, Albuquerque, 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 Desiree Renee Provencio graduated from nursing school in 2017

NPI Data:

NPI Number: 1336648328
Provider Enumeration Date: 02/06/2018
Last Update Date: 11/09/2023

Medicare PECOS Information:

PECOS PAC ID: 5496017147
Enrollment ID: I20180319000225

Medical Identifiers

Medical identifiers for Dr Desiree Renee Provencio such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1336648328	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LP0808X	Nurse Practitioner - Psychiatric/mental Health	CNP-03491 (New Mexico)	Primary

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 Desiree Renee Provencio allows following entities to bill medicare on her behalf.

Entity Name	Presbyterian Medical Services
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1871505032 PECOS PAC ID: 2062324684 Enrollment ID: O20031103000414

Entity Name	Sandia Vista Psychiatric-mental Health
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1396464723 PECOS PAC ID: 9739557950 Enrollment ID: O20221119000221

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 Desiree Renee 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 Desiree Renee Provencio, DNP, CNP, PMHNP-BC 6300 Riverside Plaza Ln Nw Ste 100, Albuquerque, NM 87120-1908 Ph: (505) 225-3110	Dr Desiree Renee Provencio, DNP, CNP, PMHNP-BC 6300 Riverside Plaza Ln Nw Ste 100, Albuquerque, NM 87120-1908 Ph: (505) 225-3110

Reviews and Comments

Nurse Practitioner Nurses in Albuquerque, NM

Mrs. Kristell L Michael, APN Nurse Practitioner Medicare: Medicare Enrolled Practice Location: Us Air Force 377 Mdg/sghc 2050a Second Street Se, Albuquerque, NM 87117 Phone: 505-846-3562 Fax: 334-953-8607
Mr. Michael Alan Wallace, CNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 8210 Louisiana Blvd Ne, Suite C, Albuquerque, NM 87113 Phone: 505-858-1222 Fax: 505-858-1224
Ms. Maureen Kolomeir, RN, CNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 5345 Wyoming Blvd, Suite 101, Albuquerque, NM 87109 Phone: 505-856-6898 Fax: 505-292-1574
Patricia J Miller, PMHNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: Care Campus, 5901 Zuni Rd Se, Albuquerque, NM 87108 Phone: 505-321-4269
Mrs. Jessika Junick, NP-C Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 3825 Eubank Blvd Ne Ste A, Albuquerque, NM 87111 Phone: 505-292-8575 Fax: 505-292-8409
Phyllis Annette Ingham, NP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1100 Lead Ave Se, Albuquerque, NM 87106 Phone: 505-224-7000
Debra Vaccaro, FNP-C Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 3500 Comanche Rd Ne Ste C, Albuquerque, NM 87107 Phone: 505-998-7200 Fax: 505-998-7220

Dr Desiree Renee Provencio, DNP, CNP, PMHNP-BC - Medicare Nurse Practitioner in Albuquerque, NM