NPIMap

Individual provider Active NPI

Jacqueline Kim Dean, MD

  • Rheumatology Physician
  • Albuquerque, NM
National Provider Identifier
1184690364
Registry record updated May 21, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
2001-170 Issued in NM
Practice address
1617 University Blvd NE
Albuquerque, NM 87102-1710
Phone
(505) 341-4841
Fax
(505) 345-9914
NPI assigned
Feb 27, 2006
Last updated
May 21, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rheumatology Physician 207RR0500X 2001-170 NM Primary

Addresses

Primary practice location

1617 University Blvd NE
Albuquerque, NM 87102-1710

Mailing address

1617 University Blvd NE
Albuquerque, NM 87102-1710
Phone (505) 341-4841

Other identifiers 1

IdentifierTypeStateIssuer
12737011MedicaidNM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091202000131 NM Practitioner - RheumatologyPractitioner - Internal Medicine 8527107754 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
RheumatologyAlso: Internal Medicine
Education
University of Louisville School of Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Albuquerque Center for Rheumatology PCGroup PAC ID 4880586650, 2 clinicians

Practice addresses (Care Compare)

1617 University Blvd NE
Albuquerque, NM 87102-1710
Phone (505) 341-4148

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.21 of 100Reported as group
Quality
88.43
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Rheumatology Specialists of Kansas City PA Past Accepting new patients
Rheumatology Specialists of Kansas City PA Rheumatology Past Accepting new patients
Taos Health Systems, Inc., Holy Cross Hospital Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/a7511550-a8b1-48d8-b97c-d2a4596e52d2/
  • Direct secure messaging: jacqueline.dean.p1@direct.acfr.nextgenshare.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 7

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": "1140998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1337558400000",
    "number": "1184690364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1617 UNIVERSITY BLVD NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871021710",
            "telephone_number": "505-341-4841",
            "fax_number": "505-345-9914"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1617 UNIVERSITY BLVD NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871021710",
            "telephone_number": "505-341-4841",
            "fax_number": "505-345-9914"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEAN",
        "first_name": "JACQUELINE",
        "middle_name": "KIM",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-27",
        "last_updated": "2012-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "NM",
            "license": "2001-170",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "12737011",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.