Individual provider Active NPI

Rhonda R Chavez, MD

  • Pediatrics Physician
  • Albuquerque, NM
National Provider Identifier
1114011582
Registry record updated May 8, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
2000159 Issued in NM
Practice address
3436 Isleta Blvd SW
PMG Isleta
Albuquerque, NM 87105-5837
Phone
(505) 462-7777
Fax
(505) 462-7880
NPI assigned
Oct 3, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 8, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 2000159 NM Primary

Addresses

Primary practice location

3436 Isleta Blvd SW
PMG Isleta
Albuquerque, NM 87105-5837

Mailing address

PO Box 26666
PHS Provider Enrollment
Albuquerque, NM 87125-6666
Phone (505) 923-5362

Other identifiers 1

IdentifierTypeStateIssuer
000N4268MedicaidNM

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100105000777 NM Practitioner - Pediatric Medicine 5395886857 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2000159NMMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Presbyterian Healthcare Services CurrentSince Nov 19, 2009 Accepting new patients
Presbyterian Healthcare Services Pediatrics CurrentSince Nov 19, 2009 Accepting new patients
Presbyterian Healthcare Services Past Accepting new patients

Locations

3630 Las Estancias Dr SW
Albuquerque, NM 87121
Phone (505) 462-7777

3436 Isleta Blvd SW
Albuquerque, NM 87105
Phone (505) 462-7777

2200 W 21st St
Clovis, NM 88101
Phone (505) 769-7577

4100 High Resort Blvd SE
Rio Rancho, NM 87124
Phone (505) 291-2770

Interoperability endpoints

  • Direct secure messaging: rchavez11748@direct.phs.org

Organizations & group practices 3

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": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1399507200000",
    "number": "1114011582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 26666",
            "address_2": "PHS PROVIDER ENROLLMENT",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871256666",
            "telephone_number": "505-923-5362",
            "fax_number": "505-923-5354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3436 ISLETA BLVD SW",
            "address_2": "PMG ISLETA",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871055837",
            "telephone_number": "505-462-7777",
            "fax_number": "505-462-7880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAVEZ",
        "first_name": "RHONDA",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-03",
        "last_updated": "2014-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NM",
            "license": "2000159",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000N4268",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.