Individual provider Active NPI

Maria Corazon Sta Ana Hizon, MD

  • Pediatric Endocrinology Physician
  • Albuquerque, NM
National Provider Identifier
1154557635
Registry record updated Dec 14, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Endocrinology PhysicianTaxonomy code 2080P0205X
License
MD2015-0743 Issued in NM
Practice address
201 Cedar St SE Ste 4640
Albuquerque, NM 87106-4922
Phone
(505) 563-6530
Fax
(505) 563-6325
NPI assigned
Jun 10, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MD2015-0743 NM
Pediatric Endocrinology Physician 2080P0205X MD2015-0743 NM Primary

Addresses

Primary practice location

201 Cedar St SE Ste 4640
Albuquerque, NM 87106-4922

Mailing address

PO Box 26666
PHS Provider Enrollment
Albuquerque, NM 87125-6666
Phone (505) 923-6770

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
I20151230001228 NM Practitioner - Pediatric MedicinePractitioner - Endocrinology 7719124635 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD2015-0743NMMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Presbyterian Healthcare Services Family Medicine CurrentSince Feb 1, 2015 Accepting new patients
Presbyterian Healthcare Services CurrentSince Feb 1, 2015 Accepting new patients
Taos Health Systems, Inc., Holy Cross Hospital Past Accepting new patients
Presbyterian Healthcare Services Past Accepting new patients

Locations

8300 Constitution Ave NE
Bldg D
Albuquerque, NM 87110
Phone (505) 291-2200

201 Cedar St SE
Ste 4640
Albuquerque, NM 87106
Phone (505) 563-6450

1100 Central Ave SE
Albuquerque, NM 87106
Phone (505) 724-6124

201 Cedar St SE
Ste 5640
Albuquerque, NM 87106
Phone (505) 563-6530

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

Interoperability endpoints

  • Direct secure messaging: mhizon93234@direct.phs.org

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.

NPI Registry JSON

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

{
    "created_epoch": "1244592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1450051200000",
    "number": "1154557635",
    "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": "505-923-6770",
            "fax_number": "505-923-5354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 CEDAR ST SE STE 4640",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871064922",
            "telephone_number": "505-563-6530",
            "fax_number": "505-563-6325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HIZON",
        "first_name": "MARIA",
        "middle_name": "CORAZON STA ANA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-10",
        "last_updated": "2015-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NM",
            "license": "MD2015-0743",
            "primary": false
        },
        {
            "code": "2080P0205X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Endocrinology",
            "state": "NM",
            "license": "MD2015-0743",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.