Marty Adelman

Key facts

NPI

1124882410

Entity type

Individual (NPI type 1)

Primary specialty

Rehabilitation Practitioner 225400000X

License

PTA1706 (NM)

Practice address

5900 Forest Hills Dr NE
Albuquerque, NM 87109-4129

Phone

(505) 822-6000

NPI assigned

Feb 8, 2024

Sex

Male

Sole proprietor

No

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

State licenses

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Feb 8, 2024.

{
    "created_epoch": "1707350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707350400000",
    "number": "1124882410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5900 FOREST HILLS DR NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871094129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5900 FOREST HILLS DR NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871094129",
            "telephone_number": "505-822-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADELMAN",
        "first_name": "MARTY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-02-08",
        "last_updated": "2024-02-08",
        "certification_date": "2024-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "NM",
            "license": "PTA1706",
            "primary": false
        },
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": "NM",
            "license": "PTA1706",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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All providers in Albuquerque, NM · Rehabilitation Practitioner in New Mexico