Individual provider Active NPI

Mark Haas, D.P.M.

  • Podiatrist
  • Albuquerque, NM
National Provider Identifier
1790782837
Registry record updated Mar 8, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
136 Issued in NM
Practice address
8080 Academy Rd NE Ste C
Albuquerque, NM 87111-1159
Phone
(505) 247-4164
NPI assigned
Jul 5, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 8, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 136 NM Primary

Addresses

Primary practice location

8080 Academy Rd NE Ste C
Albuquerque, NM 87111-1159

Mailing address

8080 Academy Rd NE Ste C
Albuquerque, NM 87111-1159
Phone (505) 247-4164

Other identifiers 3

IdentifierTypeStateIssuer
54304MedicaidNM
16483OtherNMPRESBYTERIAN PIN
NM005346OtherNMBLUE CROSS PIN

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070614000476 NM Practitioner - Podiatry 2466346903 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Albuquerque Associated Podiatrists Podiatrist CurrentSince May 23, 2008 Accepting new patients
High Desert Foot & Ankle Specialists, LLC PastSince Jan 5, 2004 Accepting new patients
Albuquerque Associated Podiatrists Podiatrist PastSince Jan 1, 1990 Accepting new patients

Locations

8080 Academy Rd NE
Ste C
Albuquerque, NM 87111
Phone (505) 247-4164

121 Sycamore St NE
Albuquerque, NM 87106
Phone (505) 247-4164

Interoperability endpoints

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

Organizations & group practices 3

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": "1120521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1268006400000",
    "number": "1790782837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8080 ACADEMY RD NE STE C",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871111159",
            "telephone_number": "505-247-4164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8080 ACADEMY RD NE STE C",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871111159",
            "telephone_number": "505-247-4164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAAS",
        "first_name": "MARK",
        "name_prefix": "Dr.",
        "credential": "D.P.M.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-05",
        "last_updated": "2010-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NM",
            "license": "136",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "54304",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRESBYTERIAN PIN",
            "identifier": "16483",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS PIN",
            "identifier": "NM005346",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.