Individual provider Active NPI

Robert Z Fialkow, M.D.

  • Nephrology Physician
  • Albuquerque, NM
National Provider Identifier
1396742268
Registry record updated Feb 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
MD2004-0712 Issued in NM
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

Updated by the provider on Feb 11, 2020

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
100032210MedicaidIN
P00409664OtherMORAILROAD 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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220811000045 GA Practitioner - Nephrology 2567374259 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
29160KYMDNephrology Physician
2007022051MOMDNephrology Physician
MD2004-0712NMMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Au Medical Associates Inc CurrentSince Sep 1, 2022 Accepting new patients
Au Medical Associates Inc CurrentSince Sep 1, 2022 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

  • Direct secure messaging: rfialkow285117@ahs.direct-ci.com
  • FHIR API: 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.

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

Verify at the official NPI Registry.