Active NPI
Michael John Walta, MD
- Emergency Medicine Physician
- Albuquerque, NM
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- MD2008-0144
- Practice address
- 1100 Central Ave SE
Albuquerque, NM 87106-4930 - Phone
- (505) 841-1125
- NPI assigned
- Dec 12, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 218547 | MA | |
| Emergency Medicine Physician | 207P00000X | MD2008-0144 | NM | Primary |
Addresses
Primary practice location
1100 Central Ave SE
Albuquerque, NM 87106-4930
Mailing address
PO Box 26666
PHS Provider Enrollment
Albuquerque, NM 87125-6666
Phone (505) 923-6770
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Emergency Medicine
- Education
- University of New Mexico School of Medicine, 2003
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
5501 Herrera Dr
B
Santa Fe, NM 87507-2684
Phone (505) 913-4180
Hospital & facility affiliations
- Christus St Vincent Regional Medical Center
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of nail tissue | 1-10 |
| Removal or shaving of skin growth | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 218547 | MA | MD | Emergency Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St. Vincent Hospital | Current | Accepting new patients | |
| Presbyterian Healthcare Services | Current | Accepting new patients | |
| St Vincent Hospital | Current | Accepting new patients | |
| St. Vincent Hospital | Current | Accepting new patients |
Locations
8300 Constitution Ave NE
Albuquerque, NM 87110
Phone (505) 291-2000
1100 Central Ave SE
Albuquerque, NM 87106
Phone (505) 724-6124
8300 Constitution Ave NE
Bldg D
Albuquerque, NM 87110
Phone (505) 291-2200
200 Emilio Lopez Rd NW
Los Lunas, NM 87031
Phone (505) 866-2700
465 Saint Michaels Dr
Ste 200
Santa Fe, NM 87505
Phone (505) 995-4901
465 Saint Michaels Dr
Ste 200
Santa Fe, NM 87505
Phone (505) 995-4901
4801 Beckner Rd
Santa Fe, NM 87507
Phone (505) 772-1234
5501 Herrera Dr
#B
Santa Fe, NM 87507
Phone (505) 913-4180
1202 Highway 60
Socorro, NM 87801
Phone (505) 835-1140
2211 Lomas Blvd NE
Unm, NM 87106
Phone (505) 272-1111
Interoperability endpoints
- mwalta283322@christushealth.direct-ci.net
Organizations & group practices 5
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.
-
- Pediatrics Physician
- Santa Fe, NM
- NPI 1063367803
-
- Internal Medicine Physician
- Albuquerque, NM
- NPI 1104802354
-
- General Acute Care Hospital
- Santa Fe, NM
- NPI 1578587150
-
- Family Medicine Physician
- Santa Fe, NM
- NPI 1245438647
-
- Urgent Care Clinic/Center
- Santa Fe, NM
- NPI 1598141152
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Santa Fe, NM
- NPI 1578587150
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165881600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1578355200000",
"number": "1770643272",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 26666",
"address_2": "PHS PROVIDER ENROLLMENT",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871256666",
"telephone_number": "505-923-6770",
"fax_number": "505-923-5354"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1100 CENTRAL AVE SE",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871064930",
"telephone_number": "505-841-1125"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALTA",
"first_name": "MICHAEL",
"middle_name": "JOHN",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-12-12",
"last_updated": "2020-01-07",
"certification_date": "2020-01-07",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "MA",
"license": "218547",
"primary": false
},
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "NM",
"license": "MD2008-0144",
"primary": true
}
],
"identifiers": [],
"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 Jan 7, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.