Individual provider Active NPI

Robert A Rader, MD

  • Internal Medicine Physician
  • Roswell, NM
National Provider Identifier
1124081864
Registry record updated Dec 26, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
89280NM Issued in NM
Practice address
402 W Country Club Road
Roswell, NM 88201
Phone
(575) 627-9500
Fax
(575) 627-9510
NPI assigned
Apr 11, 2006
Last updated
Dec 26, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 26, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 89280NM NM Primary

Addresses

Primary practice location

402 W Country Club Road
Roswell, NM 88201

Mailing address

PO Box 1574
Roswell, NM 88202
Phone (575) 627-9500

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
I20080715000375 NM Practitioner - Internal MedicinePractitioner - AnesthesiologyPractitioner - Family Practice 7911070594 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Texas Tech University Health Science Center School of Medicine, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Netherlands Anesthesia, LLCGroup PAC ID 8123433588, 41 clinicians

Practice addresses (Care Compare)

601 Dr Martin Luther King Jr Ave NE
Albuquerque, NM 87102-3619
Phone (505) 727-8000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
89280NMNMMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Netherlands Anesthesia, LLC CurrentSince Mar 31, 2021 Accepting new patients
Covenant Medical Group Internal Medicine Past Accepting new patients
Covenant Medical Group Past Accepting new patients
Lovelace Health System LLC Past Accepting new patients

Locations

601 Martin Luther King Ave NE
Albuquerque, NM 87102
Phone (505) 727-8040

Interoperability endpoints

  • Direct secure messaging: rrader10459@ahs.direct-ci.com

Organizations & group practices 4

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1144713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1324857600000",
    "number": "1124081864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1574",
            "city": "ROSWELL",
            "state": "NM",
            "postal_code": "88202",
            "telephone_number": "575-627-9500",
            "fax_number": "575-627-9510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "402 W COUNTRY CLUB ROAD",
            "city": "ROSWELL",
            "state": "NM",
            "postal_code": "88201",
            "telephone_number": "575-627-9500",
            "fax_number": "575-627-9510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RADER",
        "first_name": "ROBERT",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-11",
        "last_updated": "2011-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NM",
            "license": "89280NM",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roswell, NM

Sources for this page

Verify at the official NPI Registry.