Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Jimmy Floyd Andazola, PA-C

Individual provider Physician Assistant · NPI 1396148326

Jimmy Floyd Andazola, PA-C is a Physician Assistant in Albuquerque, New Mexico. Qualified in 2014, 12 years ago. Practices with Roper St Francis Hospital-Berkeley Inc, a 22-clinician group, works from 4 locations and accepts Medicare assignment. Licensed in Georgia, New Mexico, Oklahoma and South Carolina and 1 more.

Years since qualifying
12
Licensed in
GA, NM, OK, SC, WI
In the registry since
2014
Specialties on file
6
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

10571 Vista Bella Pl NW
Albuquerque, NM 87114-3875
Phone: (505) 259-1133
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (3)

  • 1122 Ne 13th St, Oklahoma City, OK 73117-1039 — (405) 271-1515
  • 316 Calhoun St, Charleston, SC 29401-1113 — (843) 724-2450
  • 890 W Faris Rd Ste 580, Greenville, SC 29605-4281 — (864) 455-7874

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 10494 (GA)
Physician Assistant Taxonomy 363A00000X · Licence 4505 (OK)
Medical Physician Assistant Taxonomy 363AM0700X · Licence 3518 (SC)
Physician Assistant Taxonomy 363A00000X · Licence PA2014-0051 (NM)
Physician Assistant Taxonomy 363A00000X · Licence 7337 (WI)
Medical Physician Assistant Taxonomy 363AM0700X · Licence PA2014-0051 (NM)

Record details

NPI number1396148326
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedOctober 5, 2014
Last updated in NPPESJuly 23, 2026
Certification dateJuly 23, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2014 (12 years in practice)
Group practice Roper St Francis Hospital-Berkeley Inc. — 22 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations6 on file with Medicare

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