Active NPI
John Martin Stewart, MD
- Diagnostic Radiology Physician
- Albuquerque, NM
National Provider Identifier
1538135512
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- MD20050632
- Practice address
- 8020 Constitution Place NE
#101
Albuquerque, NM 87110 - Phone
- (505) 998-1317
- Fax
- (505) 998-1308
- NPI assigned
- Feb 28, 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | MD20050632 | NM | Primary |
| Vascular & Interventional Radiology Physician | 2085R0204X | MD2005-0632 | NM |
Addresses
Primary practice location
8020 Constitution Place NE
#101
Albuquerque, NM 87110
Mailing address
8020 Constitution Place NE
#202
Albuquerque, NM 87110
Phone (505) 998-3096
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 95002839 | Medicaid | NM | |
| 974586 | Medicaid | AZ |
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
| License | State | Type | Specialty |
|---|---|---|---|
| MD20050632 | NM | MD | Diagnostic Radiology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1141084800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1329955200000",
"number": "1538135512",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8020 CONSTITUTION PLACE NE",
"address_2": "#202",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "87110",
"telephone_number": "505-998-3096",
"fax_number": "505-998-3100"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8020 CONSTITUTION PLACE NE",
"address_2": "#101",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "87110",
"telephone_number": "505-998-1317",
"fax_number": "505-998-1308"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STEWART",
"first_name": "JOHN",
"middle_name": "MARTIN",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-02-28",
"last_updated": "2012-02-23",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "NM",
"license": "MD20050632",
"primary": true
},
{
"code": "2085R0204X",
"taxonomy_group": "",
"desc": "Radiology, Vascular & Interventional Radiology",
"state": "NM",
"license": "MD2005-0632",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "95002839",
"state": "NM"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "974586",
"state": "AZ"
}
],
"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 Feb 23, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.