NPIMap

Individual provider Active NPI

Bernard M Agbemadzo, MD

  • Hematology & Oncology Physician
  • Albuquerque, NM
National Provider Identifier
1013940675
Registry record updated Jul 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
2002-0192 Issued in NM
Practice address
PMG Hematology/Oncology
8300 Constitution Ave NE
Albuquerque, NM 87110
Phone
(505) 559-6100
Fax
(505) 559-6101
NPI assigned
Jul 8, 2006
Last updated
Jul 20, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X 2002-0192 NM Primary
Medical Oncology Physician 207RX0202X 2002-0192 NM

Addresses

Primary practice location

PMG Hematology/Oncology
8300 Constitution Ave NE
Albuquerque, NM 87110

Mailing address

PO Box 26666
PHS Provider Enrollment
Albuquerque, NM 87125-6666
Phone (505) 923-5356

Other identifiers 1

IdentifierTypeStateIssuer
50057804MedicaidNM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060329000148 NM Practitioner - Hematology/OncologyPractitioner - Internal Medicine 3870501109 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Hematology/Oncology
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Presbyterian Healthcare ServicesGroup PAC ID 9234041708, 1,390 clinicians

Practice addresses (Care Compare)

2400 Unser Blvd SE
Rio Rancho, NM 87124-3392
Phone (505) 253-7878

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.68 of 100Reported as group
Quality
82.35
Promoting interoperability
100
Improvement activities
40
Cost
76.6

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Presbyterian Healthcare Services CurrentSince Sep 1, 2007 Accepting new patients
Presbyterian Healthcare Services CurrentSince Sep 1, 2007 Accepting new patients
Presbyterian Healthcare Services Past Accepting new patients
Taos Health Systems, Inc., Holy Cross Hospital Past Accepting new patients

Locations

1100 Central Ave SE
Albuquerque, NM 87106
Phone (505) 724-6124

8300 Constitution Ave NE
Albuquerque, NM 87110
Phone (505) 291-2000

2200 W 21st St
Clovis, NM 88101
Phone (505) 769-7577

2400 Unser Blvd SE
Rio Rancho, NM 87124
Phone (505) 253-0000

211 Sudderth Dr
Ruidoso, NM 88345
Phone (505) 257-7381

4801 Beckner Rd
Santa Fe, NM 87507
Phone (505) 772-1234

Interoperability endpoints

  • Direct secure messaging: bagbemadzo15849@direct.phs.org

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626739200000",
    "number": "1013940675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 26666",
            "address_2": "PHS PROVIDER ENROLLMENT",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871256666",
            "telephone_number": "505-923-5356",
            "fax_number": "505-923-5354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "PMG HEMATOLOGY/ONCOLOGY",
            "address_2": "8300 CONSTITUTION AVE NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "87110",
            "telephone_number": "505-559-6100",
            "fax_number": "505-559-6101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AGBEMADZO",
        "first_name": "BERNARD",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-08",
        "last_updated": "2021-07-20",
        "certification_date": "2021-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "NM",
            "license": "2002-0192",
            "primary": true
        },
        {
            "code": "207RX0202X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Medical Oncology",
            "state": "NM",
            "license": "2002-0192",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "50057804",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.