Individual provider Active NPI

Andres Peisajovich, MD

  • Rheumatology Physician
  • Albuquerque, NM
National Provider Identifier
1689713679
Registry record updated Jun 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
MD2008-0660 Issued in NM
Practice address
3820 Masthead St NE
Albuquerque, NM 87109-4582
Phone
(505) 205-1313
Fax
(505) 212-2164
NPI assigned
Feb 6, 2007
Last updated
Jun 20, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 2004-0383 NM
Rheumatology Physician 207RR0500X MD2008-0660 NM Primary

Addresses

Primary practice location

3820 Masthead St NE
Albuquerque, NM 87109-4582

Mailing address

3820 Masthead St NE
Albuquerque, NM 87109-4582
Phone (505) 205-1313

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
I20090722000371 NM Practitioner - Rheumatology 7618029679 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Rheumatology
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

3820 Masthead St NE
Albuquerque, NM 87109-4582
Phone (505) 205-1313

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.56 of 100Reported as individual
Quality
85.08
Improvement activities
40
Cost
81.78

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2004-0383NMMDInternal Medicine Physician
MD2008-0660NMMDRheumatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sandia Rheumatology LLC Rheumatology CurrentSince Jan 11, 2016 Accepting new patients

Locations

3820 Masthead St NE
Albuquerque, NM 87109
Phone (505) 205-1313

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/JBJDAD
  • FHIR API: https://fhir4.healow.com/fhir/r4/JBJDAD/Endpoint/JBJDAD

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1170720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466380800000",
    "number": "1689713679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3820 MASTHEAD ST NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871094582",
            "telephone_number": "505-205-1313",
            "fax_number": "505-212-2164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3820 MASTHEAD ST NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871094582",
            "telephone_number": "505-205-1313",
            "fax_number": "505-212-2164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEISAJOVICH",
        "first_name": "ANDRES",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-06",
        "last_updated": "2016-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NM",
            "license": "2004-0383",
            "primary": false
        },
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "NM",
            "license": "MD2008-0660",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.