Active NPI
Robert Z Fialkow, M.D.
- Nephrology Physician
- Albuquerque, NM
National Provider Identifier
1396742268
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nephrology Physician
- License
- MD2004-0712
- Practice address
- 3821 Masthead St NE
Albuquerque, NM 87109-4679 - Phone
- (505) 998-7400
- NPI assigned
- Jul 6, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nephrology Physician | 207RN0300X | 29160 | KY | |
| Nephrology Physician | 207RN0300X | 01040353A | IN | |
| Nephrology Physician | 207RN0300X | 2007022051 | MO | |
| Nephrology Physician | 207RN0300X | MD2004-0712 | NM | Primary |
Addresses
Primary practice location
3821 Masthead St NE
Albuquerque, NM 87109-4679
Mailing address
3821 Masthead St NE
Albuquerque, NM 87109-4679
Phone (505) 998-7400
Other practice location 1
100 Hospital Ln
Suite 145
Danville, IN 46122-1989
Phone (317) 718-2460
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100032210 | Medicaid | IN | |
| P00409664 | Other | MO | RAILROAD MEDICARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy, Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 29160 | KY | MD | Nephrology Physician |
| 2007022051 | MO | MD | Nephrology Physician |
| MD2004-0712 | NM | MD | Nephrology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Au Medical Associates Inc | Current | Accepting new patients | |
| Au Medical Associates Inc | Current | Accepting new patients | |
| Hendricks County Hospital | Past | Accepting new patients | |
| Hendricks County Hospital | Past | Accepting new patients |
Locations
1120 15th St
Augusta, GA 30912
Phone (706) 721-3873
1120 15th St
Ste OR6000
Augusta, GA 30912
Phone (706) 721-3813
Interoperability endpoints
- rfialkow285117@ahs.direct-ci.com
- https://sehproxy.stelizabeth.com/arr-fhir/api/FHIR/R4
Organizations & group practices 4
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.
-
- Multi-Specialty Clinic/Center
- Augusta, GA
- NPI 1841230620
-
- Durable Medical Equipment & Medical Supplies
- Augusta, GA
- NPI 1114574126
-
- Urgent Care Clinic/Center
- Avon, IN
- NPI 1063411551
-
- Family Medicine Physician
- Plainfield, IN
- NPI 1104927557
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1120608000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1581379200000",
"number": "1396742268",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3821 MASTHEAD ST NE",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871094679",
"telephone_number": "505-998-7400",
"fax_number": "505-998-7741"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3821 MASTHEAD ST NE",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871094679",
"telephone_number": "505-998-7400"
}
],
"practiceLocations": [
{
"address_1": "100 Hospital Ln",
"address_2": "Suite 145",
"address_purpose": "LOCATION",
"city": "Danville",
"state": "IN",
"postal_code": "461221989",
"country_code": "US",
"telephone_number": "317-718-2460",
"fax_number": "317-718-2465",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "FIALKOW",
"first_name": "ROBERT",
"middle_name": "Z",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-07-06",
"last_updated": "2020-02-11",
"certification_date": "2020-02-11",
"status": "A"
},
"taxonomies": [
{
"code": "207RN0300X",
"taxonomy_group": "",
"desc": "Internal Medicine, Nephrology",
"state": "KY",
"license": "29160",
"primary": false
},
{
"code": "207RN0300X",
"taxonomy_group": "",
"desc": "Internal Medicine, Nephrology",
"state": "IN",
"license": "01040353A",
"primary": false
},
{
"code": "207RN0300X",
"taxonomy_group": "",
"desc": "Internal Medicine, Nephrology",
"state": "MO",
"license": "2007022051",
"primary": false
},
{
"code": "207RN0300X",
"taxonomy_group": "",
"desc": "Internal Medicine, Nephrology",
"state": "NM",
"license": "MD2004-0712",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100032210",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P00409664",
"state": "MO"
}
],
"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 Feb 11, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.