Individual provider Active NPI

Mark Edward Polhemus, MD

  • Infectious Disease Physician
  • Albuquerque, NM
National Provider Identifier
1891027512
Registry record updated Oct 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
MD2022-1151 Issued in NM
Practice address
715 Dr Martin Luther King Jr Ave NE Ste 201
Albuquerque, NM 87102-3667
Phone
(505) 727-3020
Fax
(505) 727-9590
NPI assigned
Feb 5, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease Physician 207RI0200X 261872 NY
Infectious Disease Physician 207RI0200X MD2022-1151 NM Primary

Addresses

Primary practice location

715 Dr Martin Luther King Jr Ave NE Ste 201
Albuquerque, NM 87102-3667

Mailing address

800 Bradbury Dr SE Ste 116
Albuquerque, NM 87106-4310
Phone (505) 272-1476

Other practice location 1

725 Irving Ave
Suite 311
Syracuse, NY 13210-1603
Phone (315) 464-5533

Other identifiers 1

IdentifierTypeStateIssuer
03368756MedicaidNY

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address UNMH@direct.health.unm.edu
Direct Messaging Address UNMMG@direct.health.unm.edu

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, NM2 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
I20110727000337 NY Practitioner - Infectious DiseasePractitioner - Internal Medicine 0840468369 Reassigns benefits to 1 organization
I20220908003615 NM Practitioner - Infectious Disease 0840468369 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Infectious Disease
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Unm Medical Group IncGroup PAC ID 4981795267, 1,052 clinicians

Practice addresses (Care Compare)

2211 Lomas Blvd NE
Albuquerque, NM 87106-2719
Phone (505) 272-2111

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Southwest Medical Associates, LLC CurrentSince Sep 6, 2022 Accepting new patients
Department of Medicine Medical Service Group CurrentSince Aug 1, 2011 Accepting new patients
Unm Medical Group, Inc. CurrentSince Feb 20, 2024 Accepting new patients
Department of Medicine Medical Serv GRP at Suny HLTH Sci Ctr Syr in Infectious Disease CurrentSince Aug 1, 2011 Accepting new patients
Unm Medical Group Inc CurrentSince Feb 20, 2024 Accepting new patients
Southwest Medical Associates, LLC CurrentSince Sep 6, 2022 Accepting new patients
Unm Medical Group Inc Past Accepting new patients

Locations

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

933 Bradbury Dr SE
Ste 2222
Albuquerque, NM 87106
Phone (505) 272-1476

715 Martin Luther King Ave NE
Ste 201
Albuquerque, NM 87102
Phone (505) 247-9700

800 Bradbury Dr SE
Ste 116
Albuquerque, NM 87106
Phone (505) 272-1476

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

251 Salina Meadows Pkwy
Ste 100
Syracuse, NY 13212
Phone (315) 464-2000

725 Irving Ave
Ste 311
Syracuse, NY 13210
Phone (315) 464-5533

750 E Adams St
Syracuse, NY 13210
Phone (315) 464-4363

Organizations & group practices 7

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 2

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": "1265328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728432000000",
    "number": "1891027512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 BRADBURY DR SE STE 116",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871064310",
            "telephone_number": "505-272-1476",
            "fax_number": "505-727-9590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "715 DR MARTIN LUTHER KING JR AVE NE STE 201",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871023667",
            "telephone_number": "505-727-3020",
            "fax_number": "505-727-9590"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "725 Irving Ave",
            "address_2": "Suite 311",
            "address_purpose": "LOCATION",
            "city": "Syracuse",
            "state": "NY",
            "postal_code": "132101603",
            "country_code": "US",
            "telephone_number": "315-464-5533",
            "fax_number": "315-464-5579",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POLHEMUS",
        "first_name": "MARK",
        "middle_name": "EDWARD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-02-05",
        "last_updated": "2024-10-09",
        "certification_date": "2024-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "NY",
            "license": "261872",
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "NM",
            "license": "MD2022-1151",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03368756",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "UNMH@direct.health.unm.edu",
            "affiliation": "N",
            "address_1": "2211 Lomas Blvd NE",
            "city": "Albuquerque",
            "state": "NM",
            "country_code": "US",
            "postal_code": "871062719",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "UNMMG@direct.health.unm.edu",
            "affiliation": "N",
            "address_1": "800 Bradbury Dr SE Ste 116",
            "city": "Albuquerque",
            "state": "NM",
            "country_code": "US",
            "postal_code": "871064310",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.