NPIMap

Organization Active NPI

New Mexico Foot and Ankle Institute PC

  • Podiatrist
  • Albuquerque, NM
National Provider Identifier
1225103450
Registry record updated May 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
Legal business name
NEW MEXICO FOOT AND ANKLE INSTITUTE PC
Practice address
4343 Pan American Fwy NE Ste 234
Albuquerque, NM 87107-6834
Phone
(505) 880-1000
Fax
(505) 880-1002
NPI assigned
Nov 22, 2006
Last updated
May 30, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 30, 2023

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

Authorized official

Name
Nathan D IveyNPI 1144230061
Title
Owner
Phone
(505) 880-1000

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X NU Primary

Addresses

Primary practice location

4343 Pan American Fwy NE Ste 234
Albuquerque, NM 87107-6834

Mailing address

4343 Pan American Fwy NE Ste 234
Albuquerque, NM 87107-6834
Phone (505) 880-1000

Other identifiers 6

IdentifierTypeStateIssuer
201042850OtherNMPRASBYTERIAN
8571325MedicaidNM
PROVB11359OtherNMMOLINA
NM005490OtherNMBLUE CROSS BLUE SHIELD
10004402OtherNMLOVELACE
CK6674OtherRAILROAD MCR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040701000608 NM Part B Supplier - Clinic/Group Practice 8820075484 Receives reassigned benefits from 6 practitioners
Practice locations: Albuquerque, NM
O20100930058788 NM DME Supplier - Physician - PodiatryDME Supplier - Orthotic Personnel 8820075484 Practice locations: Albuquerque, NM

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
32D2163600New Mexico Foot & Ankle Institute4343 Pan American Freeway NE #234, Albuquerque, NM 87107ComplianceFeb 23, 2028

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
New Mexico Foot & Ankle Institute4343 Pan American Fwy NE, Albuquerque, NM 87107-6834(505) 880-1000 Canes and/or Crutches|Orthoses: Custom Fabricated|Orthoses: Prefabricated (Non-Custom Fabricated)|Orthoses: Off-The-Shelf|Surgical Dressings|Diabetic Shoes and Inserts|Diabetic Shoes/Inserts - Custom Accepts assignmentParticipating since Jul 1, 2002

National Provider Directory

National Provider Directory

Locations

8300 Carmel Ave NE
Ste 501
Albuquerque, NM 87122
Phone (505) 243-7600

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1164153600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1685404800000",
    "number": "1225103450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4343 PAN AMERICAN FWY NE STE 234",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871076834",
            "telephone_number": "505-880-1000",
            "fax_number": "505-880-1002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4343 PAN AMERICAN FWY NE STE 234",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871076834",
            "telephone_number": "505-880-1000",
            "fax_number": "505-880-1002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW MEXICO FOOT AND ANKLE INSTITUTE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-22",
        "last_updated": "2023-05-30",
        "certification_date": "2023-05-30",
        "status": "A",
        "authorized_official_last_name": "IVEY",
        "authorized_official_first_name": "NATHAN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "505-880-1000"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRASBYTERIAN",
            "identifier": "201042850",
            "state": "NM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8571325",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MOLINA",
            "identifier": "PROVB11359",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "NM005490",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LOVELACE",
            "identifier": "10004402",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MCR",
            "identifier": "CK6674",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 May 30, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.