Sandia Rheumatology LLC

Primary specialty

Rheumatology PhysicianTaxonomy code 207RR0500X

License

MD2008-0660 Issued in NM

Legal business name

SANDIA RHEUMATOLOGY LLC

Practice address

3820 Masthead St NE
Albuquerque, NM 87109-4582

Phone

(505) 205-1313

Fax

(505) 212-2164

NPI assigned

Dec 17, 2015

Organization subpart

No

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

Authorized official

Name

Andres Peisajovich, MDNPI 1689713679

Title

Owner

Phone

(505) 205-1313

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NM

Enrollment records 1

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/JBJDAD

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Andres Peisajovich, MD

  • Rheumatology Physician
  • Albuquerque, NM
  • NPI 1689713679
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1450310400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1466553600000",
    "number": "1386009314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3820 MASTHEAD ST NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871094582",
            "telephone_number": "505-205-1313",
            "fax_number": "505-212-2164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3820 MASTHEAD ST NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871094582",
            "telephone_number": "505-205-1313",
            "fax_number": "505-212-2164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SANDIA RHEUMATOLOGY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-17",
        "last_updated": "2016-06-22",
        "status": "A",
        "authorized_official_last_name": "PEISAJOVICH",
        "authorized_official_first_name": "ANDRES",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "505-205-1313",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Rheumatology",
            "state": "NM",
            "license": "MD2008-0660",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Rheumatology Physician in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Rheumatology Physician in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2016; 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.