Active NPI
Richard Verderame, D.D.S., M.S.
- Periodontics
- Rio Rancho, NM
National Provider Identifier
1487627618
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Periodontics
- License
- DD1612
- Practice address
- 4111 Barbara Loop SE
Suite E-2
Rio Rancho, NM 87124-1068 - Phone
- (505) 891-3000
- Fax
- (505) 891-3001
- NPI assigned
- Feb 8, 2006
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Periodontics | 1223P0300X | DD1612 | NM | Primary |
Addresses
Primary practice location
4111 Barbara Loop SE
Suite E-2
Rio Rancho, NM 87124-1068
Mailing address
4111 Barbara Loop SE
Suite E-2
Rio Rancho, NM 87124-1068
Phone (505) 891-3000
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: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20161111001221 | NM | Order and Referring Only - Oral Surgery | 8628366564 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Science
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1139356800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1487627618",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4111 BARBARA LOOP SE",
"address_2": "SUITE E-2",
"city": "RIO RANCHO",
"state": "NM",
"postal_code": "871241068",
"telephone_number": "505-891-3000",
"fax_number": "505-891-3001"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4111 BARBARA LOOP SE",
"address_2": "SUITE E-2",
"city": "RIO RANCHO",
"state": "NM",
"postal_code": "871241068",
"telephone_number": "505-891-3000",
"fax_number": "505-891-3001"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VERDERAME",
"first_name": "RICHARD",
"name_prefix": "Dr.",
"credential": "D.D.S., M.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-02-08",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "NM",
"license": "DD1612",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rio Rancho, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.