NPIMap

Individual provider Active NPI

Herbert K Holdsambeck, MD

  • Family Medicine Physician
  • Huntsville, AL
National Provider Identifier
1649251216
Registry record updated Dec 7, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
10399 Issued in AL
Practice address
420 Lowell Dr SE
Ste 403
Huntsville, AL 35801-3754
Phone
(256) 535-5980
Fax
(256) 535-5983
NPI assigned
Nov 9, 2005
Last updated
Dec 7, 2009By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 7, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 10399 AL Primary

Addresses

Primary practice location

420 Lowell Dr SE
Ste 403
Huntsville, AL 35801-3754

Mailing address

420 Lowell Dr SE
Ste 103
Huntsville, AL 35801-3754
Phone (256) 535-5940

Other identifiers 5

IdentifierTypeStateIssuer
110019467OtherRAILROAD MEDICARE
0004003561OtherAETNA
510 16799OtherALBLUE CROSS BLUE SHIELD
000016799MedicaidAL
63 0969203OtherTAX IDENTIFICATION NO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041130000949 AL Practitioner - Family Practice 1557326618 Practice locations: Huntsville, AL

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Florida College of Medicine, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

420 Lowell Dr SE
Suite 403
Huntsville, AL 35801-3754

420 Lowell Dr SE
Suite 403
Huntsville, AL 35801-3761
Phone (256) 535-5980

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
15.34 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
51.13

National Provider Directory

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

Networks

  • bcbs alabama network 01H0
  • bcbs alabama network 01C0
  • bcbs alabama network 01E0
  • bcbs alabama network 01B0
  • bcbs alabama network 01G0

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1131494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1260144000000",
    "number": "1649251216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 LOWELL DR SE",
            "address_2": "STE 103",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358013754",
            "telephone_number": "256-535-5940",
            "fax_number": "256-535-5954"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 LOWELL DR SE",
            "address_2": "STE 403",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358013754",
            "telephone_number": "256-535-5980",
            "fax_number": "256-535-5983"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLDSAMBECK",
        "first_name": "HERBERT",
        "middle_name": "K",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-09",
        "last_updated": "2009-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AL",
            "license": "10399",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "110019467",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "0004003561",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "510 16799",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000016799",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX IDENTIFICATION NO",
            "identifier": "63 0969203",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntsville, AL

Sources for this page

Verify at the official NPI Registry.