Individual provider Active NPI

Elizabeth T. Henderson, MD

  • Pediatrics Physician
  • Albuquerque, NM
National Provider Identifier
1679589386
Registry record updated Oct 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
97-74 Issued in NM
Practice address
8308 Constitution PL NE
Albuquerque, NM 87110-7637
Phone
(505) 883-9570
NPI assigned
Aug 1, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 97-74 NM Primary

Addresses

Primary practice location

8308 Constitution PL NE
Albuquerque, NM 87110-7637

Mailing address

8308 Constitution PL NE
Albuquerque, NM 87110-7637
Phone (505) 883-9570

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080401000922 NM Practitioner - Pediatric Medicine 2668559618 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Presbyterian Healthcare Services CurrentSince Mar 1, 2012 Accepting new patients
Presbyterian Healthcare Services Pediatrics CurrentSince Mar 1, 2012 Accepting new patients
University Physician Associates Past Accepting new patients
Unm Medical Group Inc Past Accepting new patients
Unm Medical Group Inc Past Accepting new patients
Journey Pediatrics PC Past Accepting new patients

Locations

8300 Constitution Ave NE
Bldg D
Albuquerque, NM 87110
Phone (505) 291-2200

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

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/20790/brand/1/csg/1/fhir/r4
  • Direct secure messaging: elizabeth.henderson.1@20790.direct.athenahealth.com

Organizations & group practices 6

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": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760486400000",
    "number": "1679589386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8308 CONSTITUTION PL NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871107637",
            "telephone_number": "505-883-9570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8308 CONSTITUTION PL NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871107637",
            "telephone_number": "505-883-9570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "ELIZABETH",
        "middle_name": "T.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-01",
        "last_updated": "2025-10-15",
        "certification_date": "2025-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NM",
            "license": "97-74",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.