Individual provider Active NPI

Phillip Ma

  • Family Nurse Practitioner
  • Albuquerque, NM
National Provider Identifier
1598315772
Registry record updated Oct 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
57390 Issued in NM
Practice address
8100 Constitution PL NE
Albuquerque, NM 87110-7643
Phone
(505) 559-1000
NPI assigned
Sep 18, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 9, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 57390 NM Primary

Addresses

Primary practice location

8100 Constitution PL NE
Albuquerque, NM 87110-7643

Mailing address

6908 Wildwood LN NE
Albuquerque, NM 87111-1073
Phone (505) 550-7134

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200619000105 NM Practitioner - Nurse Practitioner 4789006834 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of New Mexico School of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Presbyterian Healthcare ServicesGroup PAC ID 9234041708, 1,390 clinicians

Practice addresses (Care Compare)

2200 W 21St St
Clovis, NM 88101-2011
Phone (505) 769-7577

Merit-based Incentive Payment System (MIPS)

Final score
88.68 of 100Reported as group
Quality
82.35
Promoting interoperability
100
Improvement activities
40
Cost
76.6

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
57390NMMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Family Medicine PC CurrentSince Mar 13, 2020 Accepting new patients
Spencer J Hardenbrook MD PC CurrentSince May 11, 2023 Accepting new patients
Presbyterian Healthcare Services CurrentSince Sep 27, 2022 Accepting new patients
Presbyterian Healthcare Services CurrentSince Sep 27, 2022 Accepting new patients
Presbyterian Healthcare Services Past Accepting new patients

Locations

3825 Eubank Blvd NE
Ste A
Albuquerque, NM 87111
Phone (505) 292-8575

8100 Constitution Pl NE
Fl 3
Albuquerque, NM 87110
Phone (505) 559-7007

8100 Constitution Pl NE
Albuquerque, NM 87110
Phone (505) 559-1000

2200 W 21st St
Clovis, NM 88101
Phone (505) 769-7577

Interoperability endpoints

  • Direct secure messaging: pma67939@direct.phs.org

Organizations & group practices 5

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": "1568764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665273600000",
    "number": "1598315772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6908 WILDWOOD LN NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871111073",
            "telephone_number": "505-550-7134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8100 CONSTITUTION PL NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871107643",
            "telephone_number": "505-559-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MA",
        "first_name": "PHILLIP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-09-18",
        "last_updated": "2022-10-09",
        "certification_date": "2022-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NM",
            "license": "57390",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.