Individual provider Active NPI

Theresa Renee Heynekamp, MD

  • Pulmonary Disease Physician
  • Albuquerque, NM
National Provider Identifier
1821137852
Registry record updated Jan 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
MD2009-0096 Issued in NM
Practice address
500 Walter St NE Ste 501
Albuquerque, NM 87102-2521
Phone
(505) 727-3170
Fax
(505) 727-9590
NPI assigned
Feb 6, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine (Internal Medicine) Physician 207RC0200X MD2009-0096 NM
Pulmonary Disease Physician 207RP1001X MD2009-0096 NM Primary
Internal Medicine Physician 207R00000X MD2009-0096 NM

Addresses

Primary practice location

500 Walter St NE Ste 501
Albuquerque, NM 87102-2521

Mailing address

4101 Indian School Rd NE Ste 110
Albuquerque, NM 87110-3991
Phone (505) 727-3170

Other practice location 1

2211 Lomas Blvd NE
MSC 10-550
Albuquerque, NM 87106-2745
Phone (505) 272-4751

Other identifiers 1

IdentifierTypeStateIssuer
43871763MedicaidNM

Other names 1

  • Theresa Renee White Former name

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121025000523 NM Practitioner - Pulmonary DiseasePractitioner - Internal MedicinePractitioner - Critical Care (Intensivists) 3476703539 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Southwest Medical Associates, LLC CurrentSince Jul 1, 2020 Accepting new patients
Unm Medical Group Inc CurrentSince Oct 3, 2012 Accepting new patients
Southwest Medical Associates, LLC CurrentSince Jul 1, 2020 Accepting new patients
Unm Medical Group, Inc. CurrentSince Oct 3, 2012 Accepting new patients
Familycare Associates,PA Past Accepting new patients

Locations

715 Martin Luther King Ave NE
Ste 301
Albuquerque, NM 87102
Phone (505) 727-4500

4101 Indian School Rd NE
Ste 110
Albuquerque, NM 87110
Phone (505) 727-8360

500 Walter St NE
Ste 501
Albuquerque, NM 87102
Phone (505) 244-0080

2211 Lomas Blvd NE
Unm, NM 87106
Phone (505) 272-1111

Organizations & group practices 5

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": "1170720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737417600000",
    "number": "1821137852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4101 INDIAN SCHOOL RD NE STE 110",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871103991",
            "telephone_number": "505-727-3170",
            "fax_number": "505-727-9590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 WALTER ST NE STE 501",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871022521",
            "telephone_number": "505-727-3170",
            "fax_number": "505-727-9590"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2211 Lomas Blvd NE",
            "address_2": "MSC 10-550",
            "address_purpose": "LOCATION",
            "city": "Albuquerque",
            "state": "NM",
            "postal_code": "871062745",
            "country_code": "US",
            "telephone_number": "505-272-4751",
            "fax_number": "505-272-8700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HEYNEKAMP",
        "first_name": "THERESA",
        "middle_name": "RENEE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-06",
        "last_updated": "2025-01-21",
        "certification_date": "2025-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "NM",
            "license": "MD2009-0096",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "NM",
            "license": "MD2009-0096",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NM",
            "license": "MD2009-0096",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "43871763",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "THERESA",
            "last_name": "WHITE",
            "middle_name": "RENEE",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.