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DR. ETHAN BINDER M.D.
NPI 1598028540
Internal Medicine - Hematology & Oncology in Rio Rancho, NM

Active since June 24, 2012PECOS EnrolledAccepts Medicare Assignment
83.84/100
CMS Quality Rating
2400 UNSER BLVD SE, RIO RANCHO, NM 87124(505) 559-6100(505) 559-6101 Get Directions Write a Review

NPPES record last updated: June 14, 2021. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Dr. Ethan Binder M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. ETHAN BINDER M.D. (NPI 1598028540) is an individual hematology & oncology provider in Rio Rancho, New Mexico, licensed in New Mexico (MD2018-0257) and active in the NPI registry since June 2012. He is enrolled in Medicare PECOS, is affiliated with Presbyterian Hospital, and maintains a secondary practice location in Philadelphia.

NPPES Registry Identity

NPI1598028540
Entity TypeIndividualMale
Primary Taxonomy207RH0003X
Provider Legal NameDR. ETHAN BINDERCredential: M.D.
Location Address2400 UNSER BLVD SERio Rancho, NM 87124-4740
Mailing Address2400 Unser Blvd SeRio Rancho, NM 87124-4740 · (505) 559-6100 · Fax (505) 559-6101
Phone(505) 559-6100
Fax(505) 559-6101
Sole ProprietorYes
Medical School CMSOtherGraduated 2012
Enumeration DateJune 24, 2012
Last NPPES UpdateJune 14, 2021
NPPES CertifiedJune 14, 2021
✔ NPI 1598028540 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal Medicine · Hematology & OncologyAllopathic & Osteopathic Physicians
Taxonomy Code207RH0003X
License✔ Licensed in NM · MD2018-0257
Definition
An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered.
Also ListedInternal MedicineTaxonomy 207R00000X · License 202497 (PA)
2400 UNSER BLVD SE, Rio Rancho, NM 87124
Open in Google Maps ↗

Secondary Practice Location 1

Location 1245 N 15th StPhiladelphia, PA 19102-1101 · Phone (215) 762-7698

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include UnitedHealthcare.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Ethan Binder M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID6305135096
PECOS Enrollment IDI20180702002764
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Ethan Binder reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Presbyterian Healthcare Services
7.6 mi
Internal Medicine
5901 HARPER DR NE
Albuquerque, NM 87109
  • Reassigned Medicare billing, New Mexico enrollment
  • Also billed through NPI 1558347708 (New Mexico)
  • 2,331 clinicians in this Medicare group
NPI 1104802354 (505) 823-8556

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 9

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215
This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.
341 services106 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
236 services145 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
117 services98 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233
Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.
38 services15 patients
New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more 99205
This is a first-time patient visit where a healthcare professional spends 60-74 minutes with you. It involves a comprehensive evaluation, including your medical history and current health condition. They'll also advise on preventive health measures and formulate a treatment plan if needed.
27 services27 patients
Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222
Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.
20 services20 patients

Hospital Affiliations CMS Care Compare 3

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Presbyterian Hospital

Acute Care Hospitals · Albuquerque, NM
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number320021
Location1100 Central Avenue SEAlbuquerque, NM 87106 · Bernalillo County
Emergency services Birthing friendly

Presbyterian Santa Fe Medical Center

Acute Care Hospitals · Santa Fe, NM
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number320090
Location4801 Beckner RoadSanta Fe, NM 87507 · Santa Fe County
Emergency services Birthing friendly

Lincoln County Medical Center

Critical Access Hospitals · Ruidoso, NM
OwnershipVoluntary non-profit - Private
CMS Certification Number321306
Location211 Sudderth DriveRuidoso, NM 88345 · Lincoln County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 87124 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$166.80 typical visit price
range $54.26 – $166.80
Typical copayment $41.70 (range $13.56 – $41.70)
Most-billed visit code 99205
Established Patient
$96.38 typical visit price
range $17.00 – $135.35
Typical copayment $24.09 (range $4.25 – $33.83)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

83.84/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality84.59
Promoting Interoperability100
Improvement Activities40
Cost58.63

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

GRETCHEN ANN WILSON MSOTRL
Occupational Therapist
2400 UNSER BLVD SE
RIO RANCHO, NM 87124
Sandoval County (505) 401-4235
SEUNGHWAN BYUN MD
Hospitalist
2400 UNSER BLVD SE
RIO RANCHO, NM 87124
Sandoval County (505) 253-7878
DR. AZHARUDDIN MOHAMMED AKBAR SOUDAGAR M.D.
Internal Medicine
2400 UNSER BLVD SE
RIO RANCHO, NM 87124
Sandoval County (505) 253-1790
ANERI PATEL M.D.
Family Medicine
2400 UNSER BLVD SE
RIO RANCHO, NM 87124
Sandoval County (347) 647-4873
SYDNEY ROSE GEORGE PA-C
Physician Assistant
2400 UNSER BLVD SE, STE 18200
RIO RANCHO, NM 87124
Sandoval County (505) 563-6565
RAQUEL VALVERDE CPSW
Peer Specialist
2400 UNSER BLVD SE
RIO RANCHO, NM 87124
Sandoval County (505) 630-5769
DR. DOMINIC POMO DNAP, CRNA
Nurse Anesthetist, Certified Registered
2400 UNSER BLVD SE
RIO RANCHO, NM 87124
Sandoval County (505) 253-7878
ERIN MARIE GIESE RN
Registered Nurse (Medical-Surgical)
2400 UNSER BLVD SE
RIO RANCHO, NM 87124
Sandoval County (505) 253-2549

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Ethan Binder's NPI number?

The NPI number for Ethan Binder is 1598028540. It was assigned to this individual provider in the NPPES registry on June 24, 2012.

Where is Ethan Binder located?

Ethan Binder practices at 2400 Unser Blvd SE, Rio Rancho, NM 87124. The listed phone number is (505) 559-6100.

What is Ethan Binder's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Hematology & Oncology, with taxonomy code 207RH0003X.

Is Ethan Binder enrolled in Medicare?

Yes. Ethan Binder is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organization bills Medicare for Ethan Binder's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Ethan Binder reassigns Medicare benefits to Presbyterian Healthcare Services (Albuquerque, NM). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Ethan Binder's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Ethan Binder accept?

Health plans from UnitedHealthcare list Ethan Binder as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Ethan Binder affiliated with any hospitals?

According to CMS data, Ethan Binder is affiliated with Presbyterian Hospital, Presbyterian Santa Fe Medical Center and Lincoln County Medical Center.

When was this NPI record last updated?

The NPPES record for Ethan Binder was last updated on June 14, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.