NPIMap

Organization Active NPI

High Desert Foot & Ankle Specialists, LLC

  • Foot & Ankle Surgery Podiatrist
  • Albuquerque, NM
National Provider Identifier
1962901090
Registry record updated Feb 28, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
279 Issued in NM
Legal business name
HIGH DESERT FOOT & ANKLE SPECIALISTS, LLC
Practice address
9412 Indian School Rd NE
Albuquerque, NM 87112-2878
Phone
(505) 565-1155
Fax
(505) 565-1166
NPI assigned
Feb 5, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2019

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

Authorized official

Name
Tommy Gene Roe, DPM
Title
Physician/Owner
Phone
(505) 565-1155

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213ES0103X 279 NM Primary

Addresses

Primary practice location

9412 Indian School Rd NE
Albuquerque, NM 87112-2878

Mailing address

PO Box 53056
Albuquerque, NM 87153-3056
Phone (505) 565-1155

Other identifiers 2

IdentifierTypeStateIssuer
84001780MedicaidNM
55003800MedicaidNM

Other names 1

  • Valencia Associated Podiatrists Former legal business name

National Provider Directory

National Provider Directory

Locations

1003 Main St SW
Los Lunas, NM 87031
Phone (505) 565-1155

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1517788800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1551312000000",
    "number": "1962901090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 53056",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871533056",
            "telephone_number": "505-565-1155",
            "fax_number": "505-565-1166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9412 INDIAN SCHOOL RD NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871122878",
            "telephone_number": "505-565-1155",
            "fax_number": "505-565-1166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HIGH DESERT FOOT & ANKLE SPECIALISTS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-02-05",
        "last_updated": "2019-02-28",
        "status": "A",
        "authorized_official_last_name": "ROE",
        "authorized_official_first_name": "TOMMY",
        "authorized_official_middle_name": "GENE",
        "authorized_official_title_or_position": "PHYSICIAN/OWNER",
        "authorized_official_telephone_number": "505-565-1155",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "NM",
            "license": "279",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "84001780",
            "state": "NM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "55003800",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Valencia Associated Podiatrists",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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 Feb 28, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.