NPIMap

Individual provider Active NPI

William McRae Mithoefer, PA-C

  • Physician Assistant
  • Albuquerque, NM
National Provider Identifier
1972189009
Registry record updated Jun 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
2211 Lomas Blvd NE
Albuquerque, NM 87106-2719
Phone
(505) 272-2111
NPI assigned
Mar 19, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 8, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA2020-0116 NM
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

2211 Lomas Blvd NE
Albuquerque, NM 87106-2719

Mailing address

PO Box 988
El Prado, NM 87529-0988
Phone (914) 494-4087

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210901001560 NM Practitioner - Physician Assistant 7315343258 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Presbyterian Healthcare ServicesGroup PAC ID 9234041708, 1,390 clinicians

Practice addresses (Care Compare)

1100 Central Ave SE
Albuquerque, NM 87106-4930
Phone (505) 841-1234

2200 W 21St St
Clovis, NM 88101-2011
Phone (505) 769-7577

PO Box
Albuquerque, NM 87125-6666

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.68 of 100Reported as group
Quality
82.35
Promoting interoperability
100
Improvement activities
40
Cost
76.6

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA2020-0116NMMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
El Centro Family Health CurrentSince Oct 7, 2022 Accepting new patients
Presbyterian Healthcare Services CurrentSince Apr 24, 2023 Accepting new patients
El Centro Family Health CurrentSince Oct 7, 2022 Accepting new patients
Presbyterian Healthcare Services CurrentSince Apr 24, 2023 Accepting new patients
Unm Medical Group, Inc. CurrentSince May 28, 2021 Accepting new patients
Presbyterian Healthcare Services Past Accepting new patients
Taos Health Systems, Inc., Holy Cross Hospital Past Accepting new patients
El Centro Family Health Past Accepting new patients

Locations

2200 W 21st St
Clovis, NM 88101
Phone (505) 769-7577

538 N Paseo de Onate
Espanola, NM 87532
Phone (505) 753-7218

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

Interoperability endpoints

  • Direct secure messaging: wmithoefer230864@direct.phs.org

Organizations & group practices 9

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 3

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": "1616112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623110400000",
    "number": "1972189009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 988",
            "city": "EL PRADO",
            "state": "NM",
            "postal_code": "875290988",
            "telephone_number": "914-494-4087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2211 LOMAS BLVD NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871062719",
            "telephone_number": "505-272-2111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITHOEFER",
        "first_name": "WILLIAM",
        "middle_name": "MCRAE",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-03-19",
        "last_updated": "2021-06-08",
        "certification_date": "2021-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NM",
            "license": "PA2020-0116",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.