Mark Henry Pedrotty, PHD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

732 Issued in NM

Practice address

3200 Carlisle Blvd NE Ste 224
Albuquerque, NM 87110-1664

Phone

(505) 688-0601

NPI assigned

Aug 2, 2006

Last updated

Oct 6, 2022By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NM

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

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.

• Brain & Body Rehabilitation Psychotherapy LLC

  • Rehabilitation Psychologist
  • Albuquerque, NM
  • NPI 1023731825
  Medicare reassignment NPD Authorized official
• Unm Medical Group Inc

  • Multi-Specialty Clinic/Center
  • Albuquerque, NM
  • NPI 1831218627

  Single Specialty

  Medicare reassignment NPD
• Unm Medical Group, Inc.

  dba UNM Truman Health Services Pharmacy

  • Community/Retail Pharmacy
  • Albuquerque, NM
  • NPI 1417330044
  NPD

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

{
    "created_epoch": "1154476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665014400000",
    "number": "1205843265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3029 DELANO PL NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871062034",
            "telephone_number": "505-688-0601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 CARLISLE BLVD NE STE 224",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871101664",
            "telephone_number": "505-688-0601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEDROTTY",
        "first_name": "MARK",
        "middle_name": "HENRY",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-02",
        "last_updated": "2022-10-06",
        "certification_date": "2022-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NM",
            "license": "732",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NM",
            "license": "732",
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103TR0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Rehabilitation",
            "state": "NM",
            "license": "732",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "5058894598",
            "affiliation": "N",
            "endpointDescription": "fax",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "3200 Carlisle Blvd NE Ste 224",
            "city": "Albuquerque",
            "state": "NM",
            "country_code": "US",
            "postal_code": "871101664",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Pediatrix Medical Group of New Mexico, P.C.
• Elise Nicole Pedigo, PA-C
• Lilia Pedrego, MD
• Victoria M Pedroncelli
• Kurt Matthew Pedrotty, M.D.
• Yesenia Pedroza
• Peer Chiropractic Inc.
• David William Peer, DC,CCSP
• Martha D Peercy, SLP
• Benjamin C Peet, RN

• Psychologist in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Psychologist in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2022; 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.

Verify at the official NPI Registry.