Individual provider Active NPI

Stephen Hightower, MD

  • Geriatric Medicine (Internal Medicine) Physician
  • Rio Rancho, NM
National Provider Identifier
1164516548
Registry record updated Apr 13, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
License
85-45 Issued in NM
Practice address
4005 High Resort Blvd SE
Rio Rancho, NM 87124-5906
Phone
(505) 462-6000
Fax
(505) 462-8476
NPI assigned
Oct 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 8545 NM
Geriatric Medicine (Internal Medicine) Physician 207RG0300X 85-45 NM Primary

Addresses

Primary practice location

4005 High Resort Blvd SE
Rio Rancho, NM 87124-5906

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
35287MedicaidNM

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
I20130819000688 NM Practitioner - Geriatric MedicinePractitioner - Internal Medicine 0143313031 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
8545NMMDInternal Medicine Physician
85-45NMMDGeriatric Medicine (Internal Medicine) Physician
TEMPORARYTXMDHematology & Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Presbyterian Healthcare Services Internal Medicine CurrentSince Jun 20, 2013 Accepting new patients
Presbyterian Healthcare Services Internal Medicine CurrentSince Jun 20, 2013 Accepting new patients
Optumcare New Mexico LLC Past Accepting new patients

Locations

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

4005 High Resort Blvd SE
Rio Rancho, NM 87124
Phone (505) 462-6000

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

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": "1460505600000",
    "number": "1164516548",
    "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": "4005 HIGH RESORT BLVD SE",
            "city": "RIO RANCHO",
            "state": "NM",
            "postal_code": "871245906",
            "telephone_number": "505-462-6000",
            "fax_number": "505-462-8476"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HIGHTOWER",
        "first_name": "STEPHEN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2016-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NM",
            "license": "8545",
            "primary": false
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "NM",
            "license": "85-45",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "35287",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rio Rancho, NM

Sources for this page

Verify at the official NPI Registry.