NPIMap

Individual provider Active NPI

Jeffrey D Neidhart, MD

  • Hematology & Oncology Physician
  • Farmington, NM
National Provider Identifier
1801972518
Registry record updated Jun 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
2002-0176 Issued in NM
Practice address
2325 E 30TH St
Farmington, NM 87401-8900
Phone
(505) 564-6850
Fax
(505) 564-6890
NPI assigned
Oct 27, 2006
Last updated
Jun 24, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X 2002-0176 NM Primary

Addresses

Primary practice location

2325 E 30TH St
Farmington, NM 87401-8900

Mailing address

PO Box 1799
Farmington, NM 87499
Phone (505) 564-6850

Other identifiers 5

IdentifierTypeStateIssuer
T0445MedicaidUT
93002840MedicaidCO
38022222MedicaidNM
764086MedicaidAZ
NM019A39OtherNMBLUE CROSS OF NEW MEXICO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM, CO2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20041206000875 NM Practitioner - Hematology/OncologyPractitioner - Internal Medicine 5799741310 Reassigns benefits to 1 organization
I20210625000644 CO Practitioner - Hematology/OncologyPractitioner - Internal Medicine 5799741310 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hematology/OncologyAlso: Internal Medicine
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
San Juan Oncology Associates PCGroup PAC ID 6709860380, 3 clinicians

Practice addresses (Care Compare)

1305 Escalante Dr
Suite 102And103
Durango, CO 81303-8931
Phone (505) 564-6850

2325 E 30TH St
Farmington, NM 87401-8900
Phone (505) 564-6850

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
98.28
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
San Juan Oncology Associates, PC Hematology & Oncology CurrentSince Jul 25, 2021 Accepting new patients
San Juan Oncology Associates, PC Hematology & Oncology CurrentSince Jan 1, 2005 Accepting new patients
Fayette Medical Center Past Accepting new patients

Locations

1305 Escalante Dr
Ste 102103
Durango, CO 81303
Phone (505) 564-6850

2325 E 30th St
Farmington, NM 87401
Phone (505) 564-6850

735 W Animas St
Farmington, NM 87401
Phone (505) 564-6850

800 W Maple St
Farmington, NM 87401
Phone (505) 324-8870

Interoperability endpoints

  • Direct secure messaging: jeffrey.neidhart@sjonc.ikm.direct-ci.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 9

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": "1161907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624492800000",
    "number": "1801972518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1799",
            "city": "FARMINGTON",
            "state": "NM",
            "postal_code": "87499",
            "telephone_number": "505-564-6850",
            "fax_number": "505-564-6890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2325 E 30TH ST",
            "city": "FARMINGTON",
            "state": "NM",
            "postal_code": "874018900",
            "telephone_number": "505-564-6850",
            "fax_number": "505-564-6890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEIDHART",
        "first_name": "JEFFREY",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-27",
        "last_updated": "2021-06-24",
        "certification_date": "2021-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "NM",
            "license": "2002-0176",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "T0445",
            "state": "UT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "93002840",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38022222",
            "state": "NM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "764086",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF NEW MEXICO",
            "identifier": "NM019A39",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmington, NM

Sources for this page

Verify at the official NPI Registry.