Individual provider Active NPI

Brian K Donahue, MD

  • Diagnostic Radiology Physician
  • Albuquerque, NM
National Provider Identifier
1083637177
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
20050080 Issued in NM
Practice address
5400 Gibson SE
Albuquerque, NM 87108
Phone
(505) 262-7000
NPI assigned
Jul 26, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 20050080 NM Primary

Addresses

Primary practice location

5400 Gibson SE
Albuquerque, NM 87108

Mailing address

PO Box 27829
Albuquerque, NM 87125
Phone (505) 232-1920

Other identifiers 1

IdentifierTypeStateIssuer
62334310MedicaidNM

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211019002665 FL Practitioner - Diagnostic Radiology 0244203974 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20050080NMMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Elite Imaging LLC Diagnostic Radiology CurrentSince Nov 1, 2021 Accepting new patients
Elite Imaging LLC Diagnostic Radiology Current Accepting new patients
Rose Radiology Centers, LLC CurrentSince Nov 1, 2021 Accepting new patients
Orlando Diagnostic Center Inc Diagnostic Radiology CurrentSince Mar 15, 2022 Accepting new patients
Elite Imaging, LLC Diagnostic Radiology PastSince Nov 1, 2021 Accepting new patients
Optumcare Endoscopy Center New Mexico, LLC Past Accepting new patients

Locations

2999 NE 191st St
Ste 103
Aventura, FL 33180
Phone (305) 692-2222

1220 Oakfield Dr
Brandon, FL 33511
Phone (813) 655-1144

1215 Dunn Ave
Ste A
Jacksonville, FL 32218
Phone (904) 696-8400

2020 Professional Center Dr
Orange Park, FL 32073
Phone (800) 220-4661

2605 W Kennedy Blvd
Tampa, FL 33609
Phone (813) 876-7200

2229 N Commerce Pkwy
Ste 150
Weston, FL 33326
Phone (954) 349-0054

6900 Gall Blvd
Zephyrhills, FL 33542
Phone (813) 783-6736

Networks

  • Freedom Health HMO Network

Organizations & group practices 6

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": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1083637177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 27829",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "87125",
            "telephone_number": "505-232-1920",
            "fax_number": "505-727-9276"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5400 GIBSON SE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "87108",
            "telephone_number": "505-262-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DONAHUE",
        "first_name": "BRIAN",
        "middle_name": "K",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NM",
            "license": "20050080",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "62334310",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.