Individual provider Active NPI

David Mark Hardwicke, MD

  • Internal Medicine Physician
  • Albuquerque, NM
National Provider Identifier
1528093648
Registry record updated Oct 11, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
20040775 Issued in NM
Practice address
5150 Journal Center Blvd NE
Albuquerque, NM 87109
Phone
(505) 262-3212
Fax
(505) 262-3381
NPI assigned
Jul 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 20040775 NM Primary

Addresses

Primary practice location

5150 Journal Center Blvd NE
Albuquerque, NM 87109

Mailing address

PO Box 27829
Albuquerque, NM 87125
Phone (505) 232-1920

Other identifiers 1

IdentifierTypeStateIssuer
63034832MedicaidNM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20040775NMMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Optumcare Endoscopy Center New Mexico, LLC Past Accepting new patients

Organizations & group practices 1

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": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318291200000",
    "number": "1528093648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 27829",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "87125",
            "telephone_number": "505-232-1920",
            "fax_number": "505-727-9276"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5150 JOURNAL CENTER BLVD NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "87109",
            "telephone_number": "505-262-3212",
            "fax_number": "505-262-3381"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARDWICKE",
        "first_name": "DAVID",
        "middle_name": "MARK",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-11",
        "last_updated": "2011-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NM",
            "license": "20040775",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "63034832",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.