Active NPI
Michael Macdonald, HAD/HIS
- Hearing Instrument Specialist
- Rio Rancho, NM
National Provider Identifier
1083177562
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hearing Instrument Specialist
- License
- HAD0898
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 19-00152716 | Other | NM | MIRACLE EAR |
| 0898 | Other | NM | NEW MEXICO REGULATION AND LICENSING DEPARTMENT |
| HAD0898 | Other | NM | NEW 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
| License | State | Type | Specialty |
|---|---|---|---|
| HAD0898 | NM | MD | Hearing and Speech Clinic/Center |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| New Mexico Hearing Aid & Tinnitus Center LLC | Hearing and Speech | Current | 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.
-
- Hearing Aid Equipment
- Rio Rancho, NM
- NPI 1528682945
Hearing and Speech
-
- Audiologist-Hearing Aid Fitter
- Rio Rancho, NM
- NPI 1851888341
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.