Individual provider Active NPI

Deborah McGrew, MD

  • Pediatrics Physician
  • Albuquerque, NM
National Provider Identifier
1396774170
Registry record updated Jan 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD00041110 Issued in WA
Practice address
1615 University Blvd NE Ste 3
Albuquerque, NM 87102-1717
Phone
(505) 247-4100
Fax
(505) 796-5922
NPI assigned
Jul 2, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MD00041110 WA Primary
Developmental - Behavioral Pediatrics Physician 2080P0006X MD00041110 WA

Addresses

Primary practice location

1615 University Blvd NE Ste 3
Albuquerque, NM 87102-1717

Mailing address

1615 University Blvd NE Ste 3
Albuquerque, NM 87102-1717
Phone (505) 247-4100

Other identifiers 1

IdentifierTypeStateIssuer
1124536MedicaidWA

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140326002016 NM Practitioner - Pediatric Medicine 6507847217 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Presbyterian Healthcare Services CurrentSince Feb 24, 2014 Accepting new patients
Presbyterian Healthcare Services Family Medicine CurrentSince Feb 24, 2014 Accepting new patients
Highline Medical Group Inc Family Medicine Past Accepting new patients

Locations

2200 W 21st St
Clovis, NM 88101
Phone (505) 769-7577

Organizations & group practices 3

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": "1151798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641513600000",
    "number": "1396774170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1615 UNIVERSITY BLVD NE STE 3",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871021717",
            "telephone_number": "505-247-4100",
            "fax_number": "505-796-5922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1615 UNIVERSITY BLVD NE STE 3",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871021717",
            "telephone_number": "505-247-4100",
            "fax_number": "505-796-5922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCGREW",
        "first_name": "DEBORAH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-02",
        "last_updated": "2022-01-07",
        "certification_date": "2022-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WA",
            "license": "MD00041110",
            "primary": true
        },
        {
            "code": "2080P0006X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Developmental - Behavioral Pediatrics",
            "state": "WA",
            "license": "MD00041110",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1124536",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.