NPIMap

Organization Active NPI

Heartland Hospice Services, LLC

Doing business as ProMedica Hospice (Albuquerque)

  • Hospice and Palliative Medicine (Internal Medicine) Physician
  • Albuquerque, NM
National Provider Identifier
1215653522
Registry record updated Oct 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospice and Palliative Medicine (Internal Medicine) PhysicianTaxonomy code 207RH0002X
Legal business name
HEARTLAND HOSPICE SERVICES, LLC
Doing business as
ProMedica Hospice (Albuquerque)
Practice address
4001 Indian School Rd NE Ste 300
Albuquerque, NM 87110-3853
Phone
(505) 323-1464
NPI assigned
Oct 18, 2022
Last updated
Oct 18, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2022

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

Authorized official

Name
Martin David Allen
Title
Director
Phone
(419) 252-5734

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hospice and Palliative Medicine (Internal Medicine) Physician 207RH0002X NU Primary

Addresses

Primary practice location

4001 Indian School Rd NE Ste 300
Albuquerque, NM 87110-3853

Mailing address

333 N Summit St
Toledo, OH 43604-1531
Phone (567) 585-1191

Other identifiers 1

IdentifierTypeStateIssuer
49109316MedicaidNM

Other names 1

  • ProMedica Hospice (Albuquerque) Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200921003024 NM Part B Supplier - Clinic/Group Practice 4789592536 Receives reassigned benefits from 1 practitioner
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Albuquerque, NM

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Heartland Hospice SVCS LLC33 organizations share this tax ID, including this one

Other organizations with this tax ID 32

Organizations that report the same tax identification number in the National Provider Directory.

View all 32

Locations

4001 Indian School Rd NE
Ste 300
Albuquerque, NM 87110
Phone (505) 323-1464

NPI Registry JSON

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

{
    "created_epoch": "1666051200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1666051200000",
    "number": "1215653522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 N SUMMIT ST",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436041531",
            "telephone_number": "567-585-1191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4001 INDIAN SCHOOL RD NE STE 300",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871103853",
            "telephone_number": "505-323-1464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEARTLAND HOSPICE SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-18",
        "last_updated": "2022-10-18",
        "certification_date": "2022-10-18",
        "status": "A",
        "authorized_official_last_name": "ALLEN",
        "authorized_official_first_name": "MARTIN",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "419-252-5734"
    },
    "taxonomies": [
        {
            "code": "207RH0002X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hospice and Palliative Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "49109316",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ProMedica Hospice (Albuquerque)",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Albuquerque, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.