Individual provider Active NPI

Jon Hallstrom

  • Diagnostic Radiology Physician
  • Albuquerque, NM
National Provider Identifier
1508039686
Registry record updated Mar 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
MB2014-0117 Issued in NM
Practice address
2211 Lomas Blvd NE
Albuquerque, NM 87106-2719
Phone
(505) 272-2269
Fax
(505) 272-5821
NPI assigned
Apr 9, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X A125160 CA
Student in an Organized Health Care Education/Training Program 390200000X
Diagnostic Radiology Physician 2085R0202X MB2014-0117 NM Primary

Addresses

Primary practice location

2211 Lomas Blvd NE
Albuquerque, NM 87106-2719

Mailing address

800 Bradbury Dr SE Ste 116
Albuquerque, NM 87106-4310

Electronic endpoints 4

TypeEndpointUseAffiliation
Direct Messaging Address UNMH@direct.health.unm.edu
Direct Messaging Address UNMCCC@direct.health.unm.edu
Direct Messaging Address UNMH@direct.health.unm.edu
Direct Messaging Address UNMMG@direct.health.unm.edu

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
I20140829000125 NM Practitioner - Diagnostic Radiology 0446478689 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Ohio State University College of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Unm Medical Group IncGroup PAC ID 4981795267, 1,052 clinicians

Practice addresses (Care Compare)

2211 Lomas Blvd NE
Albuquerque, NM 87106-2719
Phone (505) 272-2111

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.64 of 100Reported as group
Quality
75.49
Promoting interoperability
100
Improvement activities
40
Cost
76.92

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A125160CAMDDiagnostic Radiology Physician
MB2014-0117NMMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Unm Medical Group, Inc. CurrentSince Jul 1, 2014 Accepting new patients
Unm Medical Group Inc CurrentSince Jul 1, 2014 Accepting new patients

Locations

933 Bradbury Dr SE
Ste 2222
Albuquerque, NM 87106
Phone (505) 272-1476

800 Bradbury Dr SE
Ste 116
Albuquerque, NM 87106
Phone (505) 272-1476

1201 Camino de Salud NE
Albuquerque, NM 87102
Phone (505) 272-4443

3001 Broadmoor Blvd NE
Rio Rancho, NM 87144
Phone (505) 994-7000

2211 Lomas Blvd NE
Unm, NM 87106
Phone (505) 272-1111

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": "1207699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741824000000",
    "number": "1508039686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 BRADBURY DR SE STE 116",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871064310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2211 LOMAS BLVD NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871062719",
            "telephone_number": "505-272-2269",
            "fax_number": "505-272-5821"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALLSTROM",
        "first_name": "JON",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-04-09",
        "last_updated": "2025-03-13",
        "certification_date": "2025-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "A125160",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NM",
            "license": "MB2014-0117",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "UNMH@direct.health.unm.edu",
            "affiliation": "N",
            "address_1": "2211 Lomas Blvd NE",
            "city": "Albuquerque",
            "state": "NM",
            "country_code": "US",
            "postal_code": "871062719",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "UNMCCC@direct.health.unm.edu",
            "affiliation": "N",
            "address_1": "1201 Camino De Salud NE",
            "city": "Albuquerque",
            "state": "NM",
            "country_code": "US",
            "postal_code": "871024517",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "UNMH@direct.health.unm.edu",
            "affiliation": "N",
            "address_1": "3001 Broadmoor Blvd NE",
            "city": "Rio Rancho",
            "state": "NM",
            "country_code": "US",
            "postal_code": "871442100",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "UNMMG@direct.health.unm.edu",
            "affiliation": "N",
            "address_1": "800 Bradbury Dr SE Ste 116",
            "city": "Albuquerque",
            "state": "NM",
            "country_code": "US",
            "postal_code": "871064310",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.