Individual provider Active NPI

Lisa Khalil Ereifej, MD

  • Endocrinology, Diabetes & Metabolism Physician
  • Albuquerque, NM
National Provider Identifier
1508142050
Registry record updated Nov 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
MD2017-0615 Issued in NM
Practice address
6701 Jefferson St NE
Albuquerque, NM 87109
Phone
(505) 727-6200
Fax
(505) 727-9590
NPI assigned
Oct 28, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 18, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X NM
Endocrinology, Diabetes & Metabolism Physician 207RE0101X MD2017-0615 NM Primary

Addresses

Primary practice location

6701 Jefferson St NE
Albuquerque, NM 87109

Mailing address

6701 Jefferson St NE
Albuquerque, NM 87109-4318
Phone (505) 727-6200

Other practice location 1

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

Other practice location 2

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

Other identifiers 1

IdentifierTypeStateIssuer
75250080MedicaidNM

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
I20170920001681 NM Practitioner - Endocrinology 0547494668 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Endocrinology
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southwest Medical Associates, LLCGroup PAC ID 7214831114, 326 clinicians

Practice addresses (Care Compare)

6701 Jefferson St NE
Albuquerque, NM 87109-4318
Phone (505) 727-6200

715 Dr Martin Luther King Jr Ave NE
Suite 301
Albuquerque, NM 87102-3668
Phone (505) 727-7090

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Southwest Medical Associates, LLC CurrentSince Aug 1, 2017 Accepting new patients
Southwest Medical Associates, LLC CurrentSince Aug 1, 2017 Accepting new patients

Locations

4101 Indian School Rd NE
Ste 110
Albuquerque, NM 87110
Phone (505) 727-8360

715 Martin Luther King Ave NE
Ste 301
Albuquerque, NM 87102
Phone (505) 727-4500

6701 Jefferson St NE
Albuquerque, NM 87109
Phone (505) 727-0600

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1319760000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574035200000",
    "number": "1508142050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6701 JEFFERSON ST NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871094318",
            "telephone_number": "505-727-6200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6701 JEFFERSON ST NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "87109",
            "telephone_number": "505-727-6200",
            "fax_number": "505-727-9590"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2211 Lomas Blvd NE",
            "address_2": "UNM Hospital",
            "address_purpose": "LOCATION",
            "city": "Albuquerque",
            "state": "NM",
            "postal_code": "87106",
            "country_code": "US",
            "telephone_number": "505-272-2111",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2211 Lomas Blvd NE",
            "address_2": "UNM Hospital",
            "address_purpose": "LOCATION",
            "city": "Albuquerque",
            "state": "NM",
            "postal_code": "87106",
            "country_code": "US",
            "telephone_number": "505-272-2111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EREIFEJ",
        "first_name": "LISA",
        "middle_name": "KHALIL",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-10-28",
        "last_updated": "2019-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "NM",
            "license": null,
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "NM",
            "license": "MD2017-0615",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "75250080",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.