Active NPI
Robert S Mals, MD
- Diagnostic Radiology Physician
- Albuquerque, NM
National Provider Identifier
1801819909
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- 20030403
- Practice address
- 601 Dr Martin Luther King Jr Ave NE
Albuquerque, NM 87102-3619 - Phone
- (505) 298-0301
- Fax
- (505) 323-5203
- NPI assigned
- Jul 26, 2006
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Body Imaging Physician | 2085B0100X | 20030403 | NM | |
| Diagnostic Radiology Physician | 2085R0202X | 20030403 | NM | Primary |
| Vascular & Interventional Radiology Physician | 2085R0204X | 20030403 | NM |
Addresses
Primary practice location
601 Dr Martin Luther King Jr Ave NE
Albuquerque, NM 87102-3619
Mailing address
PO Box 4934
Albuquerque, NM 87196-4934
Phone (505) 298-0301
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 95579753 | 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 |
|---|---|---|---|
| 20030403 | NM | MD | Diagnostic Radiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Commonwealth Radiology Associates, Inc | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Specialist
- Salem, MA
- NPI 1295711661
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153872000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1468454400000",
"number": "1801819909",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 4934",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871964934",
"telephone_number": "505-298-0301"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "601 DR MARTIN LUTHER KING JR AVE NE",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871023619",
"telephone_number": "505-298-0301",
"fax_number": "505-323-5203"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MALS",
"first_name": "ROBERT",
"middle_name": "S",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-26",
"last_updated": "2016-07-14",
"status": "A"
},
"taxonomies": [
{
"code": "2085B0100X",
"taxonomy_group": "",
"desc": "Radiology, Body Imaging",
"state": "NM",
"license": "20030403",
"primary": false
},
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "NM",
"license": "20030403",
"primary": true
},
{
"code": "2085R0204X",
"taxonomy_group": "",
"desc": "Radiology, Vascular & Interventional Radiology",
"state": "NM",
"license": "20030403",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "95579753",
"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 Jul 14, 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.