Active NPI
Shelley A Katz, M.D.
- Endocrinology, Diabetes & Metabolism Physician
- Albuquerque, NM
National Provider Identifier
1780666982
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Endocrinology, Diabetes & Metabolism Physician
- License
- SK078965
- Practice address
- 5400 Canyon Bluff TRL NE
Albuquerque, NM 87111-8239 - Phone
- (505) 508-1029
- NPI assigned
- Nov 15, 2005
- Last updated
- Nov 20, 2012
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | RS2012-0788 | NM | |
| Endocrinology, Diabetes & Metabolism Physician | 207RE0101X | SK078965 | MI | Primary |
Addresses
Primary practice location
5400 Canyon Bluff TRL NE
Albuquerque, NM 87111-8239
Mailing address
5400 Canyon Bluff TRL NE
Albuquerque, NM 87111-8239
Phone (505) 508-1029
Other identifiers 18
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 562533142 | Other | MI | UNITED HEALTH CARE PLANS |
| 0P23930 | Other | MI | MICHIGAN MEDICARE PLUS BL |
| 024544 | Other | MI | MIDWEST HEALTH PLAN |
| 104932923 | Medicaid | MI | |
| SK078965 | Other | MI | MICHIGAN STATE LICENSE |
| 1108140971 | Other | MI | BCBS OF MICHIGAN PIN |
| 142240 | Other | MI | CARE CHOICES PIN |
| 562533142 | Other | MI | MICHIGAN TAX ID |
| RS2012-0788 | Other | NM | LICENSE NUMBER |
| 562533142 | Other | MI | WASHTENAW HEALTH PLAN |
| 562533142 | Other | MI | PPOM |
| 6U4933 | Other | MI | HEALTH ALLIANCE PLAN HMO |
| 142240 | Other | MI | PREFERRED CHOICES |
| 17388 | Other | MI | M-CARE HMO |
| 562533142 | Other | MI | CIGNA HEALTH PLANS |
| 562533142 | Other | MI | HARVARD PILGRIM NATIONAL |
| 562533142 | Other | MI | CHAMPUS TRICARE |
| A4238872 | Other | MI | AETNA PLANS |
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 |
|---|---|---|---|
| SK078965 | MI | MD | Endocrinology, Diabetes & Metabolism Physician |
| RS2012-0788 | NM | MD | Student in an Organized Health Care Education/Training Program |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1132012800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1353369600000",
"number": "1780666982",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5400 CANYON BLUFF TRL NE",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871118239",
"telephone_number": "505-508-1029"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5400 CANYON BLUFF TRL NE",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871118239",
"telephone_number": "505-508-1029"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KATZ",
"first_name": "SHELLEY",
"middle_name": "A",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2005-11-15",
"last_updated": "2012-11-20",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "NM",
"license": "RS2012-0788",
"primary": false
},
{
"code": "207RE0101X",
"taxonomy_group": "",
"desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
"state": "MI",
"license": "SK078965",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTH CARE PLANS",
"identifier": "562533142",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MICHIGAN MEDICARE PLUS BL",
"identifier": "0P23930",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MIDWEST HEALTH PLAN",
"identifier": "024544",
"state": "MI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "104932923",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MICHIGAN STATE LICENSE",
"identifier": "SK078965",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS OF MICHIGAN PIN",
"identifier": "1108140971",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CARE CHOICES PIN",
"identifier": "142240",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MICHIGAN TAX ID",
"identifier": "562533142",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE NUMBER",
"identifier": "RS2012-0788",
"state": "NM"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WASHTENAW HEALTH PLAN",
"identifier": "562533142",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PPOM",
"identifier": "562533142",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH ALLIANCE PLAN HMO",
"identifier": "6U4933",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PREFERRED CHOICES",
"identifier": "142240",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "M-CARE HMO",
"identifier": "17388",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA HEALTH PLANS",
"identifier": "562533142",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HARVARD PILGRIM NATIONAL",
"identifier": "562533142",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CHAMPUS TRICARE",
"identifier": "562533142",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA PLANS",
"identifier": "A4238872",
"state": "MI"
}
],
"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 Nov 20, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.