PRESBYTERIAN MEDICAL GROUP
NPI 1104802354
Internal Medicine in Albuquerque, NM
NPI Status: Active since December 20, 2005
Contact Information
5901 HARPER DR NE
ALBUQUERQUE, NM
ZIP 87109
Phone: (505) 823-8556
Fax: (505) 823-8555
- Organization
- Internal Medicine
- Accepts Insurance
- CLIA Number: 32D2150247
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 06-19-2026
About PRESBYTERIAN MEDICAL GROUP
This page provides the complete NPI Profile along with additional information for Presbyterian Medical Group, an internist established in Albuquerque, New Mexico operating as a Internal Medicine. The healthcare provider is registered in the NPI registry with number 1104802354 assigned on December 2005. The practitioner's primary taxonomy code is 207R00000X. The provider is registered as an organization and their NPI record was last updated 14 years ago. Presbyterian Medical Group operates as a Multi-Specialty Group with one or more individual practitioners, who practice different areas of specialization. The provider's is doing business as Presbyterian Medical Group. The authorized official of this NPI record is Mr. Clay Holderman (Coo/cds)
- NPI
- 1104802354
- Provider Legal Name
- PRESBYTERIAN HEALTHCARE SERVICES
- Other Organization Name
- PRESBYTERIAN MEDICAL GROUP
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 5901 HARPER DR NE ALBUQUERQUE, NM 87109
- Location Phone
- (505) 823-8556
- Location Fax
- (505) 823-8555
- Mailing Address
- PO BOX 26666 PROVIDER ENROLLMENT ALBUQUERQUE, NM 87125
- Mailing Phone
- (505) 923-5356
- Mailing Fax
- (505) 823-8555
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 12-20-2005
- Last Update Date
- 08-30-2012
- Code Navigator
An internist like Presbyterian Medical Group is a physician who has completed an internal medicine residency and is board-certified or board-eligible in an internist specialty. Internists are trained to care for adults of all ages for many different medical conditions. An internist typically monitors chronic physical conditions, identifies acute diseases, provides family planning, provides counseling about wellness and disease prevention, etc.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Internal Medicine
- Taxonomy Code
- 207R00000X
- Type
- Allopathic & Osteopathic Physicians
- Taxonomy Description
- A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 207Q00000X | Allopathic & Osteopathic Physicians | Family Medicine | |
| 2 | 207T00000X | Allopathic & Osteopathic Physicians | Neurological Surgery | |
| 3 | 207V00000X | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | |
| 4 | 207ZP0105X | Allopathic & Osteopathic Physicians | Pathology | |
| 5 | 208000000X | Allopathic & Osteopathic Physicians | Pediatrics | |
| 6 | 2084N0400X | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | |
| 7 | 2085R0001X | Allopathic & Osteopathic Physicians | Radiology | |
| 8 | 208600000X | Allopathic & Osteopathic Physicians | Surgery | |
| 9 | 208VP0000X | Allopathic & Osteopathic Physicians | Pain Medicine | |
| 10 | 213E00000X | Podiatric Medicine & Surgery Service Providers | Podiatrist | |
| 11 | 261QU0200X | Ambulatory Health Care Facilities | Clinic/Center | |
| 12 | 291U00000X | Laboratories | Clinical Medical Laboratory | (NM) |
Group Taxonomy 193200000X MULTI-SPECIALTY GROUP
This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Choice Bronze HSA - HMO
- Choice Bronze HSA + Vision + Adult Dental - HMO
- Complete Gold - HMO
- Complete Gold + Vision + Adult Dental - HMO
- Complete Silver - HMO
- Complete Silver + Vision + Adult Dental - HMO
- Elite Gold - HMO
- Elite Gold + Vision + Adult Dental - HMO
- Everyday Bronze - HMO
- Everyday Bronze + Vision + Adult Dental - HMO
- Complete Gold - EPO
- Complete Gold + Vision + Adult Dental - EPO
- Enhanced Diabetes Care Silver with $0 Drug Options - EPO
- Enhanced Diabetes Care Silver with $0 Drug Options + Vision + Adult Dental - EPO
- Everyday Gold - EPO
- Everyday Gold + Vision + Adult Dental - EPO
- Focused Silver - EPO
- Focused Silver + Vision + Adult Dental - EPO
- Standard Gold - EPO
- Standard Gold + Vision + Adult Dental - EPO
- Elite Bronze - PPO
- Elite Bronze + Vision + Adult Dental - PPO
- Elite Gold - PPO
- Elite Gold + Vision + Adult Dental - PPO
- Enhanced Asthma/COPD Care Silver with $0 Drug Options - PPO
- Enhanced Asthma/COPD Care Silver with $0 Drug Options + Vision + Adult Dental - PPO
- Enhanced Diabetes Care Silver with $0 Drug Options - PPO
- Enhanced Diabetes Care Silver with $0 Drug Options + Vision + Adult Dental - PPO
- Everyday Bronze - PPO
- Everyday Bronze + Vision + Adult Dental - PPO
- UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care) - HMO
- UHC Bronze Essential ($0 Virtual Urgent Care) - HMO
- UHC Bronze Standard - HMO
- UHC Bronze Standard+ (Dental + Vision) - HMO
- UHC Gold Advantage ($0 Virtual Urgent Care, $8 Tier 2 Rx) - HMO
- UHC Gold Advantage+ ($0 Virtual Urgent Care, $8 Tier 2 Rx, Dental + Vision) - HMO
- UHC Gold Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, $8 Tier 2 Rx) - HMO
- UHC Gold Copay Focus+ $0 Indiv Med Ded ($0 Virtual Urgent Care, $8 Tier 2 Rx, Dental + Vision) - HMO
- UHC Gold Standard - HMO
- UHC Silver Advantage ($0 Virtual Urgent Care, $5 Tier 2 Rx) - HMO
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| =========C | MEDICARE PIN (08) | NM |
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 32D2150247
- Facility Type
- Physician Office
- Certificate Effective Date
- June 20, 2024
- Certificate Expiration Date
- June 19, 2026
- Laboratory Director
- DR. DAMARA KAPLAN
- Certificate Type
- Certificate for Provider-Performed Microscopy Procedures (PPMP)
- Certificate Type Description
- This CLIA certificate is issued to Presbyterian Medical Group in which a physician, midlevel practitioner or dentist that performs specific microscopy procedures during the course of a patient's visit. A limited list of provider-performed microscopy procedures is included under this certificate type, which are categorized as moderate complexity testing.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1104802354, we treat the final digit (4) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 46. The final step is to find the difference between that total and the next multiple of ten (50 - 46 = 4).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 46 is 50. The difference is the calculated check digit.
Other Providers at the Same Location
The following 20 providers are registered at the same or a nearby location.
ALBUQUERQUE, NM 87109
ALBUQUERQUE, NM 87109
ALBUQUERQUE, NM 87109
ALBUQUERQUE, NM 87109
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1104802354, enumerated as an "organization" on December 20, 2005.
The provider is located at 5901 HARPER DR NE ALBUQUERQUE, NM 87109 and the phone number is (505) 823-8556.
Internal Medicine with taxonomy code 207R00000X.
The provider might be accepting Accepts: Ambetter from Arizona Complete Health, Ambetter. Please consult your insurance carrier or call the provider to verify.
