Individual provider Active NPI

Braden Randall Hale, MD, MPH

  • Infectious Disease Physician
  • Albuquerque, NM
National Provider Identifier
1598737587
Registry record updated Sep 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
MD2020-0838 Issued in NM
Practice address
1 University of New Mexico # 105550
Albuquerque, NM 87131-1098
Phone
(505) 272-5666
Fax
(505) 272-4435
NPI assigned
Feb 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease Physician 207RI0200X G79430 CA
Infectious Disease Physician 207RI0200X MD2020-0838 NM Primary

Addresses

Primary practice location

1 University of New Mexico # 105550
Albuquerque, NM 87131-1098

Mailing address

34800 Bob Wilson Dr
Nmcsd, Attn: Medical Staff Services
San Diego, CA 92134-1098
Phone (619) 532-6460

Other practice location 1

34800 Bob Wilson Dr
Nmcsd, Attn: Medical Staff Services
San Diego, CA 92134-1098
Phone (619) 532-6460

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
79430CAMDPharmacist
G79430CAMDInfectious Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of California Current Accepting new patients

Locations

200 W Arbor Dr
San Diego, CA 92103
Phone (619) 543-5754

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": "1138924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600300800000",
    "number": "1598737587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34800 BOB WILSON DR",
            "address_2": "NMCSD, ATTN: MEDICAL STAFF SERVICES",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921341098",
            "telephone_number": "619-532-6460",
            "fax_number": "619-532-6299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 UNIVERSITY OF NEW MEXICO # 105550",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871311098",
            "telephone_number": "505-272-5666",
            "fax_number": "505-272-4435"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "34800 Bob Wilson Dr",
            "address_2": "NMCSD, ATTN: MEDICAL STAFF SERVICES",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921341098",
            "country_code": "US",
            "telephone_number": "619-532-6460",
            "fax_number": "619-532-6299",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HALE",
        "first_name": "BRADEN",
        "middle_name": "RANDALL",
        "name_prefix": "Dr.",
        "credential": "MD, MPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-03",
        "last_updated": "2020-09-17",
        "certification_date": "2020-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "CA",
            "license": "G79430",
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "NM",
            "license": "MD2020-0838",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.