Lida Fatemi, D.O.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

A187315 Issued in NM

Practice address

4550 Eubank Blvd NE Ste 108
Albuquerque, NM 87111-2565

Phone

(702) 886-7075

Fax

(505) 272-8060

NPI assigned

Mar 27, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Doctor of Medicine

State licenses

Practice roles

Locations

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• Holding Hands Hospice

  • Community Based Hospice Care Agency
  • Los Angeles, CA
  • NPI 1518591783

  Contracted Managing Employee

  CMS ownership
• Lavila Hospice Inc

  • Community Based Hospice Care Agency
  • Glendale, CA
  • NPI 1265079685

  Contracted Managing Employee

  CMS ownership

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.

• Evolve Abq Professional Corporation

  • Primary Care Clinic/Center
  • Albuquerque, NM
  • NPI 1952293466

  NM

  Medicare reassignment NPD Authorized official
• Unm Medical Group Inc

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

  NM

  Medicare reassignment NPD
• Abq Hospice & Palliative Care Co.

  • Community Based Hospice Care Agency
  • Albuquerque, NM
  • NPI 1306685847
  NPD
• Unm Medical Group, Inc.

  • Community/Retail Pharmacy
  • Albuquerque, NM
  • NPI 1417330044
  NPD
• Abq Medical Equipment Co

  • Durable Medical Equipment & Medical Supplies
  • Albuquerque, NM
  • NPI 1407667264
  NPD (past)

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

{
    "created_epoch": "1332806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770163200000",
    "number": "1295001048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4550 EUBANK BLVD NE STE 107",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871112565",
            "telephone_number": "505-485-2545",
            "fax_number": "505-657-7309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4550 EUBANK BLVD NE STE 108",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871112565",
            "telephone_number": "702-886-7075",
            "fax_number": "505-272-8060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FATEMI",
        "first_name": "LIDA",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-27",
        "last_updated": "2026-02-04",
        "certification_date": "2026-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NM",
            "license": "A187315",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Jalayne Faulhaber, FNP
• Martha Jane Faulkner, PHD, PMHNP, FNP

• All providers in Albuquerque, NM
• Internal Medicine Physician in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.