Individual provider Active NPI

Heidimae Regina Martin, PA-S

  • Physician Assistant
  • Albuquerque, NM
National Provider Identifier
1417633306
Registry record updated Oct 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA2024-0138 Issued in NM
Practice address
MSC 09 5040 1 Unm
Albuquerque, NM 87131
Phone
(505) 620-6567
NPI assigned
Jun 26, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2025

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 PA2024-0138 NM Primary

Addresses

Primary practice location

MSC 09 5040 1 Unm
Albuquerque, NM 87131

Mailing address

MSC 09 5040 1 Unm
Albuquerque, NM 87131

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
I20250212002672 NM Practitioner - Physician Assistant 2466982996 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orthopedic Associates PAGroup PAC ID 1355254244, 19 clinicians

Practice addresses (Care Compare)

2300 E 30TH St
Farmington, NM 87401-8990
Phone 50532714002528

Hospital & facility affiliations

  • San Juan Regional Medical Center Inc Hospital, Farmington, NM, CCN 320005

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA2024-0138NMMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Orthopedic Associates PA CurrentSince Jan 6, 2025 Accepting new patients

Locations

3180 N Butler Ave
#300
Farmington, NM 87401
Phone (505) 226-7893

2300 E 30th St
Bldg D-101
Farmington, NM 87401
Phone (505) 327-1400

2300 E 30th St
Ste 101
Farmington, NM 87401
Phone (505) 208-6280

Organizations & group practices 2

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 2

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": "1687737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761609600000",
    "number": "1417633306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "MSC 09 5040 1 UNM",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "87131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MSC 09 5040 1 UNM",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "87131",
            "telephone_number": "505-620-6567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "HEIDIMAE",
        "middle_name": "REGINA",
        "credential": "PA-S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-26",
        "last_updated": "2025-10-28",
        "certification_date": "2025-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NM",
            "license": "PA2024-0138",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.