Active NPI
Robert A Rader, MD
- Internal Medicine Physician
- Roswell, NM
National Provider Identifier
1124081864
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 89280NM
- Practice address
- 402 W Country Club Road
Roswell, NM 88201 - Phone
- (575) 627-9500
- Fax
- (575) 627-9510
- NPI assigned
- Apr 11, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932187044 | Other | NM | GROUP NPI |
| 800521089 | Other | NM | MCR GROUP NUMBER |
| 00020065NM | Medicaid | NM | |
| Z2565 | Other | NM | MCD GROUP NUMBER |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20080715000375 | NM | Practitioner - Internal Medicine | 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
Practice addresses (Care Compare)
601 Dr Martin Luther King Jr Ave NE
Albuquerque, NM 87102-3619
Phone (505) 727-8000
Hospital & facility affiliations
- Lovelace Regional Hospital - Roswell
- Eastern New Mexico Medical Center
- Lincoln County Medical Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 89280NM | NM | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Netherlands Anesthesia, LLC | Current | Accepting new patients | |
| Covenant Medical Group | Internal Medicine | Past | Accepting new patients |
| Lovelace Health System LLC | Past | Accepting new patients | |
| Covenant Medical Group | Past | Accepting new patients |
Locations
601 Martin Luther King Ave NE
Albuquerque, NM 87102
Phone (505) 727-8040
117 E 19th St
Roswell, NM 88201
Phone (505) 727-2000
Interoperability endpoints
- 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 and National Provider Directory roles.
-
- General Acute Care Hospital
- Roswell, NM
- NPI 1972878361
-
- Rural Health Clinic/Center
- Abernathy, TX
- NPI 1538412895
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": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GROUP NPI",
"identifier": "1932187044",
"state": "NM"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MCR GROUP NUMBER",
"identifier": "800521089",
"state": "NM"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00020065NM",
"state": "NM"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MCD GROUP NUMBER",
"identifier": "Z2565",
"state": "NM"
}
],
"endpoints": [],
"other_names": []
}Other providers in Roswell, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.