Individual provider Active NPI

Jody Masters, PA

  • Physician Assistant
  • Albuquerque, NM
National Provider Identifier
1356501431
Registry record updated Jun 12, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA2006-0044 Issued in NM
Practice address
4316 Carlisle Blvd NE
Ste C
Albuquerque, NM 87107-4829
Phone
(505) 888-1075
Fax
(505) 888-1082
NPI assigned
Jun 12, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA2006-0044 NM Primary

Addresses

Primary practice location

4316 Carlisle Blvd NE
Ste C
Albuquerque, NM 87107-4829

Mailing address

4316 Carlisle Blvd NE
Ste C
Albuquerque, NM 87107-4829
Phone (505) 888-1075

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090916000470 NM Practitioner - Physician Assistant 8224184239 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southwest Medical Associates, LLCGroup PAC ID 7214831114, 326 clinicians

Practice addresses (Care Compare)

601 Dr Martin Luther King Jr Ave NE
Albuquerque, NM 87102-3619
Phone (505) 727-8000

715 Dr Martin Luther King Jr Ave NE
Suite 301
Albuquerque, NM 87102-3668
Phone (505) 727-7090

Hospital & facility affiliations

  • Lovelace Medical Center Hospital, Albuquerque, NM, CCN 320009

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Southwest Medical Associates, LLC CurrentSince Feb 25, 2017 Accepting new patients

Locations

715 Martin Luther King Ave NE
Ste 301
Albuquerque, NM 87102
Phone (505) 727-4500

601 Martin Luther King Ave NE
Albuquerque, NM 87102
Phone (505) 727-8040

4101 Indian School Rd NE
Ste 110
Albuquerque, NM 87110
Phone (505) 727-8360

Interoperability endpoints

  • Direct secure messaging: jmasters9531@ahs.direct-ci.com

Organizations & group practices 1

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 1

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": "1213228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213228800000",
    "number": "1356501431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4316 CARLISLE BLVD NE",
            "address_2": "STE C",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871074829",
            "telephone_number": "505-888-1075",
            "fax_number": "505-888-1082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4316 CARLISLE BLVD NE",
            "address_2": "STE C",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871074829",
            "telephone_number": "505-888-1075",
            "fax_number": "505-888-1082"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASTERS",
        "first_name": "JODY",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-12",
        "last_updated": "2008-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NM",
            "license": "PA2006-0044",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.