Individual provider Active NPI

Nathaly Cortez Bazan, MD

  • Gastroenterology Physician
  • Albuquerque, NM
National Provider Identifier
1265923080
Registry record updated Jul 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
MD2024-0180 Issued in NM
Practice address
1100 Lead Ave SE
Albuquerque, NM 87106-5215
Phone
(505) 224-7000
Fax
(505) 224-7292
NPI assigned
May 29, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X MD2024-0180 NM Primary

Addresses

Primary practice location

1100 Lead Ave SE
Albuquerque, NM 87106-5215

Mailing address

PO Box 26666
Albuquerque, NM 87125-6666

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
I20240911002955 NM Practitioner - GastroenterologyPractitioner - Internal Medicine 1355881772 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
GastroenterologyAlso: Internal Medicine
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Presbyterian Healthcare ServicesGroup PAC ID 9234041708, 1,390 clinicians

Practice addresses (Care Compare)

1100 Lead Ave SE
Albuquerque, NM 87106-5215
Phone (505) 224-7000

Hospital & facility affiliations

  • Presbyterian Hospital Hospital, Albuquerque, NM, CCN 320021

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy92
Upper gastrointestinal (GI) endoscopy for acid reflux87

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Presbyterian Healthcare Services CurrentSince Aug 6, 2024 Accepting new patients
Presbyterian Healthcare Services CurrentSince Aug 6, 2024 Accepting new patients
Presbyterian Healthcare Services Past Accepting new patients

Locations

1100 Lead Ave SE
Albuquerque, NM 87106
Phone (505) 224-7000

2421 W 21st St
Ste B
Clovis, NM 88101
Phone (575) 742-7824

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

2400 Unser Blvd SE
Ste 19100
Rio Rancho, NM 87124
Phone (505) 224-7000

Interoperability endpoints

  • Direct secure messaging: ncortezbazan253536@direct.phs.org

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.

Hospital & facility affiliations 2

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": "1527552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719964800000",
    "number": "1265923080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 26666",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871256666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 LEAD AVE SE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871065215",
            "telephone_number": "505-224-7000",
            "fax_number": "505-224-7292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORTEZ BAZAN",
        "first_name": "NATHALY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-29",
        "last_updated": "2024-07-03",
        "certification_date": "2024-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NM",
            "license": "MD2024-0180",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.