505 Foot Care LLC
Organization Active NPI Podiatrist · Albuquerque, NM
NPI 1578093803 · NPPES record last updated Oct 23, 2020
Key facts
- NPI
- 1578093803
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Podiatrist 213E00000X
- License
- 393 (NM)
- Legal business name
- 505 FOOT CARE LLC
- Practice address
- 8019 Lava Reach Ave NW Ste a
Albuquerque, NM 87120-6531 - Phone
- (505) 210-2113
- Fax
- (505) 962-0701
- NPI assigned
- Jun 19, 2017
- Organization subpart
- No
Authorized official
- Name
- Dr. Benjamin J Hockin, DPM
- Title
- Sole MBR
- Phone
- (505) 210-2113
Practitioners 1
-
Benjamin J Hockin, DPM
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NM
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20170630000303 | NM | Part B Supplier - Clinic/Group Practice | 6103195441 |
Receives reassigned benefits from 1 practitioner Practice locations: Albuquerque, NM |
National Provider Directory
Locations
4811 Hardware Dr NE
Ste C-5
Albuquerque, NM 87109
Phone (505) 210-2113
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Podiatrist |
213E00000X | 393 | NM | Yes |
Addresses
Primary practice location
8019 Lava Reach Ave NW Ste a
Albuquerque, NM 87120-6531
Mailing address
8019 Lava Reach Ave NW Ste a
Albuquerque, NM 87120-6531
Phone (505) 210-2113
Other names
- BENJAMIN HOCKIN DPM
Other providers in Albuquerque, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 23, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.