Individual provider Active NPI

Maria Hultquist

  • Medical Physician Assistant
  • Albuquerque, NM
National Provider Identifier
1073221313
Registry record updated Mar 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
Practice address
4824 McMahon Blvd NW Ste 109
Albuquerque, NM 87114-5412
Phone
(505) 379-5037
NPI assigned
Nov 7, 2022
Last updated
Mar 2, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X Primary

Addresses

Primary practice location

4824 McMahon Blvd NW Ste 109
Albuquerque, NM 87114-5412

Mailing address

4609 Taylor Ridge Rd NW
Albuquerque, NM 87120-5716
Phone (505) 379-5037

Other names 1

  • Maria Marion Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230426001247 NM Practitioner - Physician Assistant 4880059864 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Interventional Pain AssociatesGroup PAC ID 9537598263, 4 clinicians

Practice addresses (Care Compare)

4824 McMahon Blvd NW
Suite 109
Albuquerque, NM 87114-5412
Phone (505) 588-7246

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1667779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677715200000",
    "number": "1073221313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4609 TAYLOR RIDGE RD NW",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871205716",
            "telephone_number": "505-379-5037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4824 MCMAHON BLVD NW STE 109",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871145412",
            "telephone_number": "505-379-5037"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HULTQUIST",
        "first_name": "MARIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-11-07",
        "last_updated": "2023-03-02",
        "certification_date": "2023-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARIA",
            "last_name": "MARION",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.