Individual provider Active NPI

Brian R Mumford, MD

  • Diagnostic Radiology Physician
  • Albuquerque, NM
National Provider Identifier
1801812854
Registry record updated Mar 13, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
MD2013-0778 Issued in NM
Practice address
4411 The 25 Way NE
Suite 150
Albuquerque, NM 87109-5857
Phone
(505) 332-6900
Fax
(505) 332-6921
NPI assigned
Jul 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X MD2013-0778 NM Primary

Addresses

Primary practice location

4411 The 25 Way NE
Suite 150
Albuquerque, NM 87109-5857

Mailing address

4411 The 25 Way NE
Suite 150
Albuquerque, NM 87109-5857
Phone (505) 332-6900

Other identifiers 1

IdentifierTypeStateIssuer
1533118MedicaidNM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR, UT2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20041004000617 OR Practitioner - Diagnostic Radiology 9436118775 Reassigns benefits to 1 organization
I20070102000242 UT Practitioner - Diagnostic Radiology 9436118775

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Utah School of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1151 E 3900 S Number
B150
Salt Lake City, UT 84124-1253

27020 Pacific Hwy S
Suite a 502
Kent, WA 98032

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.15 of 100Reported as group
Quality
90
Improvement activities
40
Cost
78.43

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD2013-0778NMMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Revere Health PC Past Accepting new patients
Body Imaging PC Diagnostic Radiology Past Accepting new patients
Advanced Imaging LLC Past Accepting new patients

Organizations & group practices 4

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.

Hospital & facility affiliations 5

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": "1152835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1394668800000",
    "number": "1801812854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4411 THE 25 WAY NE",
            "address_2": "SUITE 150",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871095857",
            "telephone_number": "505-332-6900",
            "fax_number": "505-332-6921"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4411 THE 25 WAY NE",
            "address_2": "SUITE 150",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871095857",
            "telephone_number": "505-332-6900",
            "fax_number": "505-332-6921"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUMFORD",
        "first_name": "BRIAN",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-14",
        "last_updated": "2014-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NM",
            "license": "MD2013-0778",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1533118",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.