Active NPI
Ronald Deyhle, MD
- Gynecology Physician
- Albuquerque, NM
National Provider Identifier
1740259977
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gynecology Physician
- License
- 83-188
- Practice address
- 4705 Montgomery Blvd NE
Suite 301
Albuquerque, NM 87109-1226 - Phone
- (505) 727-4500
- Fax
- (505) 727-4505
- NPI assigned
- Mar 17, 2006
- Last updated
- Feb 5, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gynecology Physician | 207VG0400X | 83-188 | NM | Primary |
Addresses
Primary practice location
4705 Montgomery Blvd NE
Suite 301
Albuquerque, NM 87109-1226
Mailing address
4705 Montgomery Blvd NE
Suite 301
Albuquerque, NM 87109-1226
Phone (505) 727-4500
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00035741 | Medicaid | NM |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 83-188 | NM | MD | Gynecology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1142553600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1454630400000",
"number": "1740259977",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4705 MONTGOMERY BLVD NE",
"address_2": "SUITE 301",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871091226",
"telephone_number": "505-727-4500",
"fax_number": "505-727-4505"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4705 MONTGOMERY BLVD NE",
"address_2": "SUITE 301",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871091226",
"telephone_number": "505-727-4500",
"fax_number": "505-727-4505"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEYHLE",
"first_name": "RONALD",
"name_prefix": "Mr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-17",
"last_updated": "2016-02-05",
"status": "A"
},
"taxonomies": [
{
"code": "207VG0400X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology, Gynecology",
"state": "NM",
"license": "83-188",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00035741",
"state": "NM"
}
],
"endpoints": [],
"other_names": []
}Other providers in Albuquerque, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.