Individual provider Active NPI

Winona Stoltzfus, MD

  • Public Health & General Preventive Medicine Physician
  • Albuquerque, NM
National Provider Identifier
1053387811
Registry record updated Feb 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Public Health & General Preventive Medicine PhysicianTaxonomy code 2083P0901X
License
2001-110 Issued in NM
Practice address
300 San Mateo Blvd NE Ste 902
Albuquerque, NM 87108-1507
Phone
(505) 222-8684
Fax
(505) 222-8675
NPI assigned
Feb 23, 2006
Last updated
Feb 18, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 2001-110 NM
Public Health & General Preventive Medicine Physician 2083P0901X 2001-110 NM Primary

Addresses

Primary practice location

300 San Mateo Blvd NE Ste 902
Albuquerque, NM 87108-1507

Mailing address

300 San Mateo Blvd NE Ste 902
Albuquerque, NM 87108-1507
Phone (505) 222-8684

Other identifiers 1

IdentifierTypeStateIssuer
F2345MedicaidNM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2001-110NMMDPublic Health & General Preventive Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1140652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1392681600000",
    "number": "1053387811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 SAN MATEO BLVD NE STE 902",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871081507",
            "telephone_number": "505-222-8684",
            "fax_number": "505-222-8675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 SAN MATEO BLVD NE STE 902",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871081507",
            "telephone_number": "505-222-8684",
            "fax_number": "505-222-8675"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOLTZFUS",
        "first_name": "WINONA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-23",
        "last_updated": "2014-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NM",
            "license": "2001-110",
            "primary": false
        },
        {
            "code": "2083P0901X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Public Health & General Preventive Medicine",
            "state": "NM",
            "license": "2001-110",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "F2345",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.