Individual provider Active NPI

Michael Macdonald, HAD/HIS

  • Hearing Instrument Specialist
  • Rio Rancho, NM
National Provider Identifier
1083177562
Registry record updated Jan 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hearing Instrument SpecialistTaxonomy code 237700000X
License
HAD0898 Issued in NM
Practice address
5553 Lilac PL NE
Rio Rancho, NM 87144-5804
Phone
(505) 235-0110
Fax
(505) 771-2353
NPI assigned
Apr 10, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 3, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hearing Instrument Specialist 237700000X HAD0898 NM Primary
Hearing and Speech Clinic/Center 261QH0700X HAD0898 NM

Addresses

Primary practice location

5553 Lilac PL NE
Rio Rancho, NM 87144-5804

Mailing address

5553 Lilac PL NE
Rio Rancho, NM 87144-5804
Phone (505) 771-2353

Other practice location 1

10052 Coors Blvd NW
Albuquerque, NM 87114-4020
Phone (505) 235-0110

Other identifiers 3

IdentifierTypeStateIssuer
19-00152716OtherNMMIRACLE EAR
0898OtherNMNEW MEXICO REGULATION AND LICENSING DEPARTMENT
HAD0898OtherNMNEW MEXICO REGULATION AND LICENSING DEPARTMENT

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
HAD0898NMMDHearing and Speech Clinic/Center

Practice roles

OrganizationSpecialtyStatusNew patients
New Mexico Hearing Aid & Tinnitus Center LLC Hearing and Speech CurrentSince Jan 17, 2022 Accepting new patients
Menm LLC Past Accepting new patients

Locations

10052 Coors Blvd NW
Albuquerque, NM 87114
Phone (505) 235-0110

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1554854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641168000000",
    "number": "1083177562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5553 LILAC PL NE",
            "city": "RIO RANCHO",
            "state": "NM",
            "postal_code": "871445804",
            "telephone_number": "505-771-2353",
            "fax_number": "505-771-2353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5553 LILAC PL NE",
            "city": "RIO RANCHO",
            "state": "NM",
            "postal_code": "871445804",
            "telephone_number": "505-235-0110",
            "fax_number": "505-771-2353"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10052 Coors Blvd NW",
            "address_purpose": "LOCATION",
            "city": "Albuquerque",
            "state": "NM",
            "postal_code": "871144020",
            "country_code": "US",
            "telephone_number": "505-235-0110",
            "fax_number": "505-771-2353",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MACDONALD",
        "first_name": "MICHAEL",
        "credential": "HAD/HIS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-04-10",
        "last_updated": "2022-01-03",
        "certification_date": "2022-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "237700000X",
            "taxonomy_group": "",
            "desc": "Hearing Instrument Specialist",
            "state": "NM",
            "license": "HAD0898",
            "primary": true
        },
        {
            "code": "261QH0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Hearing and Speech",
            "state": "NM",
            "license": "HAD0898",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MIRACLE EAR",
            "identifier": "19-00152716",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEW MEXICO REGULATION AND LICENSING DEPARTMENT",
            "identifier": "0898",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEW MEXICO REGULATION AND LICENSING DEPARTMENT",
            "identifier": "HAD0898",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rio Rancho, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2022; 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.