Active NPI
Mareth E. Williams, M.D.
- Pediatrics Physician
- Albuquerque, NM
National Provider Identifier
1972640191
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 91-350
- Practice address
- 2300 Menaul Blvd NE
Albuquerque, NM 87107-1851 - Phone
- (505) 272-3000
- Fax
- (505) 272-0386
- NPI assigned
- Jan 30, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 91-350 | NM | Primary |
Addresses
Primary practice location
2300 Menaul Blvd NE
Albuquerque, NM 87107-1851
Mailing address
800 Bradbury Dr SE Ste 116
Albuquerque, NM 87106-4310
Phone (505) 272-1476
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| E0116 | Medicaid | NM | |
| 1-Z4593 | Medicaid | UT | |
| 200110750A | Medicaid | IN | |
| 91913509 | Medicaid | CO | |
| 0975102 | Medicaid | IA | |
| 208137703 | Medicaid | MO |
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| 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 NM
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 91-350 | NM | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Unm Medical Group Inc | Current | Accepting new patients | |
| Unm Medical Group, Inc. | Current | Accepting new patients | |
| University Physician Associates | Past | Accepting new patients |
Locations
933 Bradbury Dr SE
Ste 2222
Albuquerque, NM 87106
Phone (505) 272-1476
800 Bradbury Dr SE
Ste 116
Albuquerque, NM 87106
Phone (505) 272-1476
2211 Lomas Blvd NE
Unm, NM 87106
Phone (505) 272-1111
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 and National Provider Directory roles.
-
- Multi-Specialty Clinic/Center
- Albuquerque, NM
- NPI 1831218627
-
- Community/Retail Pharmacy
- Albuquerque, NM
- NPI 1417330044
-
- Multi-Specialty Clinic/Center
- Albuquerque, NM
- NPI 1265468086
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170115200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1730246400000",
"number": "1972640191",
"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"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2300 MENAUL BLVD NE",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871071851",
"telephone_number": "505-272-3000",
"fax_number": "505-272-0386"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLIAMS",
"first_name": "MARETH",
"middle_name": "E.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-30",
"last_updated": "2024-10-30",
"certification_date": "2024-10-30",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NM",
"license": "91-350",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "E0116",
"state": "NM"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1-Z4593",
"state": "UT"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200110750A",
"state": "IN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "91913509",
"state": "CO"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0975102",
"state": "IA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "208137703",
"state": "MO"
}
],
"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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.