Individual provider Active NPI

William M Roethel, M.D.

  • Emergency Medicine Physician
  • Albuquerque, NM
National Provider Identifier
1669433017
Registry record updated Jan 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
MD2006-0621 Issued in NM
Practice address
601 Martin Luther King Ave NE
Albuquerque, NM 87102-3619
Phone
(505) 727-8000
NPI assigned
Mar 28, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 23, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X MD2006-0621 NM Primary
Emergency Medical Services (Emergency Medicine) Physician 207PE0004X 4301054529 MI

Addresses

Primary practice location

601 Martin Luther King Ave NE
Albuquerque, NM 87102-3619

Mailing address

601 Martin Luther King Ave NE
Albuquerque, NM 87102-3619
Phone (505) 727-8000

Other identifiers 2

IdentifierTypeStateIssuer
103311354MedicaidMI
WR054529OtherMIBC/BS OF MI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM, WA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20070210000136 NM Practitioner - Emergency Medicine 3678575248 Reassigns benefits to 1 organization
I20091027000904 WA Practitioner - Emergency Medicine 3678575248

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD2006-0621NMMDEmergency Medicine Physician
4301054529MIMDEmergency Medical Services (Emergency Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southwest Emergency Medical Associates of NM PC Emergency Medicine CurrentSince Aug 1, 2023 Accepting new patients

Locations

601 Martin Luther King Ave NE
Albuquerque, NM 87102
Phone (505) 727-8040

4701 Montgomery Blvd NE
Albuquerque, NM 87109
Phone (505) 727-2000

900 W Ash St
Deming, NM 88030
Phone (505) 546-2761

2450 S Telshor Blvd
Las Cruces, NM 88011
Phone (505) 522-8641

Interoperability endpoints

  • Direct secure messaging: wroethel10678@ahs.direct-ci.com

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": "1143504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737590400000",
    "number": "1669433017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 MARTIN LUTHER KING AVE NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871023619",
            "telephone_number": "505-727-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 MARTIN LUTHER KING AVE NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871023619",
            "telephone_number": "505-727-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROETHEL",
        "first_name": "WILLIAM",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-28",
        "last_updated": "2025-01-23",
        "certification_date": "2025-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NM",
            "license": "MD2006-0621",
            "primary": true
        },
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "MI",
            "license": "4301054529",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103311354",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS OF MI",
            "identifier": "WR054529",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.