INSERT INTO `providers_new` (`Provider_Tax_ID`, `Provider_Suffix`, `Provider_Network_ID`, `Provider_Region`, `Provider_Name`, `Provider_Doctor_First_Name`, `Provider_Doctor_Middle_Name`, `Provider_Doctor_Last_Name`, `Provider_Doctor_Degree`, `Provider_Specialty_1`, `Provider_Specialty_2`, `Provider_Specialty_3`, `Provider_Specialty_4`, `Provider_Address_Type`, `Provider_Address`, `Provider_City`, `Provider_County`, `Provider_State`, `Provider_Zip`, `Provider_Phone`, `Provider_Fax`, `Provider_Mailing_Address`, `Provider_Mailing_City`, `Provider_Mailing_County`, `Provider_Mailing_State`, `Provider_Mailing_Zip`, `Provider_Mailing_Phone`, `Provider_Mailing_Fax`, `Provider_Primary_Schedule`, `Provider_Secondary_Schedule`, `Provider_Rate_Sheet`, `Provider_Anes_Rate`, `Provider_Default_Rate`, `Provider_Max_DOS`, `Provider_Min_Match_Value`, `Provider_Effective_Date`, `Provider_Term_Date`, `Provider_Pend`, `Provider_Anes_Minutes`, `Provider_PPO`, `Provider_Hospital_1`, `Provider_Hospital_2`, `Provider_Hospital_3`, `Provider_Hospital_4`, `Provider_Type`, `Provider_NPI`, `Provider_Check_Override`, `Exclude_Dir`, `Audit_Status`, `Last_Change_Date`, `Medicare_ID`, `Provider_Lang`, `Provider_Latitude`, `Provider_Longitude`, `Provider_school`, `Provider_cert`) VALUES
('204043287', 'ABQ000408', 'ABQ000408', 'NM01', 'ABQ Health Partners', 'Claudia', '', 'Anison', 'MD', 'Hospitalist', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5057278039', '5057278086', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5057278039', '5057278086', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1770516270', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000009', 'ABQ000009', 'NM01', 'ABQ Health Partners', 'Chidinma', '', 'Anozie', 'MD', 'Family Practice', '', '', NULL, 'O', '1721 Rio Rancho Blvd SE', 'Rio Rancho', 'Sandoval', 'NM', '87124', '5058968600', '5058968618', '1721 Rio Rancho Blvd SE', 'Rio Rancho', 'Sandoval', 'NM', '87124', '5058968600', '5058968618', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1982851192', 0, 'N', 0, '2011-10-20', NULL, NULL, 35.2284, -106.66, NULL, NULL),
('204043287', 'ABQ000809', 'ABQ000809', 'NM01', 'ABQ Health Partners', 'Chidinma', '', 'Anozie', 'MD', 'Family Practice', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5058968600', '5058968618', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5058968600', '5058968618', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1982851192', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000409', 'ABQ000409', 'NM01', 'ABQ Health Partners', 'Chidinma', '', 'Anozie', 'MD', 'Family Practice', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5058968600', '5058968618', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5058968600', '5058968618', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1982851192', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000010', 'ABQ000010', 'NM01', 'ABQ Health Partners', 'Todd', '', 'Armbruster', 'DO', 'Family Practice', '', '', NULL, 'O', '2929 Coors Blvd NW Ste 200', 'Albuquerque', 'Bernalillo', 'NM', '87120', '5058392300', '5058392303', '2929 Coors Blvd NW Ste 200', 'Albuquerque', 'Bernalillo', 'NM', '87120', '5058392300', '5058392303', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2013-10-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1487670824', 0, 'N', 0, '2013-09-04', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000810', 'ABQ000810', 'NM01', 'ABQ Health Partners', 'Todd', '', 'Armbruster', 'DO', 'Family Practice', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5058392300', '5058392303', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5058392300', '5058392303', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2013-10-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1487670824', 0, 'N', 0, '2013-09-04', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000410', 'ABQ000410', 'NM01', 'ABQ Health Partners', 'Todd', '', 'Armbruster', 'DO', 'Family Practice', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5058392300', '5058392303', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5058392300', '5058392303', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2013-10-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1487670824', 0, 'N', 0, '2013-09-04', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000011', 'ABQ000011', 'NM01', 'ABQ Health Partners', 'Teresa', '', 'Balcomb', 'MD', 'Orthopedic Surgery/Hand', '', '', NULL, 'O', '101 Hospital Loop NE Ste 201', 'Albuquerque', 'Bernalillo', 'NM', '87109', '5052627375', '5052627776', '101 Hospital Loop NE Ste 201', 'Albuquerque', 'Bernalillo', 'NM', '87109', '5052627375', '5052627776', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2013-10-01', 0, 0, 0, 'Lovelace Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1245311034', 0, 'N', 0, '2013-09-09', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000811', 'ABQ000811', 'NM01', 'ABQ Health Partners', 'Teresa', '', 'Balcomb', 'MD', 'Orthopedic Surgery/Hand', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052627375', '5052627776', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052627375', '5052627776', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1245311034', 0, 'N', 0, '2013-09-09', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000411', 'ABQ000411', 'NM01', 'ABQ Health Partners', 'Teresa', '', 'Balcomb', 'MD', 'Orthopedic Surgery/Hand', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052627375', '5052627776', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052627375', '5052627776', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1245311034', 0, 'N', 0, '2013-09-09', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000012', 'ABQ000012', 'NM01', 'ABQ Health Partners', 'Jehad', '', 'Barakat', 'MD', 'Gastroenterology', '', '', NULL, 'O', '5400 Gibson Blvd SE', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052627174', '5052623562', '5400 Gibson Blvd SE', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052627174', '5052623562', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2012-09-30', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1770598229', 0, 'N', 0, '2012-09-27', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000412', 'ABQ000412', 'NM01', 'ABQ Health Partners', 'Jehad', '', 'Barakat', 'MD', 'Gastroenterology', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052627174', '5052623562', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052627174', '5052623562', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2012-09-30', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1770598229', 0, 'N', 0, '2012-09-27', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000013', 'ABQ000013', 'NM01', 'ABQ Health Partners', 'Elizabeth', '', 'Batcher', 'MD', 'Endocrinology', '', '', NULL, 'O', '5400 Gibson Blvd SE', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052627455', '5052623955', '5400 Gibson Blvd SE', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052627455', '5052623955', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1316045495', 0, 'N', 0, '2011-10-20', NULL, NULL, 35.0583, -106.582, NULL, NULL),
('204043287', 'ABQ000413', 'ABQ000413', 'NM01', 'ABQ Health Partners', 'Elizabeth', '', 'Batcher', 'MD', 'Endocrinology', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052627455', '5052623955', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052627455', '5052623955', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1316045495', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000014', 'ABQ000014', 'NM01', 'ABQ Health Partners', 'Dorothy', '', 'Beach', 'CNM', 'Obstetrics and Gynecology', '', '', NULL, 'O', '5150 Journal Ctr Blvd NE', 'Albuquerque', 'Bernalillo', 'NM', '87109', '5052546500', '5052623198', '5150 Journal Ctr Blvd NE', 'Albuquerque', 'Bernalillo', 'NM', '87109', '5052546500', '5052623198', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Womens Hospital', '', '', '', 'HCFA|UB|', '1639192826', 0, 'N', 0, '2014-06-19', NULL, NULL, 35.1702, -106.586, NULL, NULL),
('204043287', 'ABQ000814', 'ABQ000814', 'NM01', 'ABQ Health Partners', 'Dorothy', '', 'Beach', 'CNM', 'Obstetrics and Gynecology', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052546500', '5052623198', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052546500', '5052623198', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Womens Hospital', '', '', '', 'HCFA|UB|', '1639192826', 0, 'N', 0, '2014-06-19', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000414', 'ABQ000414', 'NM01', 'ABQ Health Partners', 'Dorothy', '', 'Beach', 'CNM', 'Obstetrics and Gynecology', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052546500', '5052623198', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052546500', '5052623198', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Womens Hospital', '', '', '', 'HCFA|UB|', '1639192826', 0, 'N', 0, '2014-06-19', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000015', 'ABQ000015', 'NM01', 'ABQ Health Partners', 'Jeffrey', '', 'Becker', 'MD', 'Dermatology', '', '', NULL, 'O', '5400 Gibson Blvd SE', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052627097', '5052627636', '5400 Gibson Blvd SE', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052627097', '5052627636', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1689666166', 0, 'N', 0, '2011-10-20', NULL, NULL, 35.0583, -106.582, NULL, NULL),
('204043287', 'ABQ000415', 'ABQ000415', 'NM01', 'ABQ Health Partners', 'Jeffrey', '', 'Becker', 'MD', 'Dermatology', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052627097', '5052627636', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052627097', '5052627636', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1689666166', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000016', 'ABQ000016', 'NM01', 'ABQ Health Partners', 'Beth', '', 'Begay', 'MD', 'Hospitalist', '', '', NULL, 'O', '500 Walter St NE Ste 401', 'Albuquerque', 'Bernalillo', 'NM', '87102', '5057278039', '5057278086', '500 Walter St NE Ste 401', 'Albuquerque', 'Bernalillo', 'NM', '87102', '5057278039', '5057278086', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1164561163', 0, 'N', 0, '2014-06-13', NULL, NULL, 35.0863, -106.64, NULL, NULL),
('204043287', 'ABQ000816', 'ABQ000816', 'NM01', 'ABQ Health Partners', 'Beth', '', 'Begay', 'MD', 'Hospitalist', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5057278039', '5057278086', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5057278039', '5057278086', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1164561163', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000416', 'ABQ000416', 'NM01', 'ABQ Health Partners', 'Beth', '', 'Begay', 'MD', 'Hospitalist', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5057278039', '5057278086', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5057278039', '5057278086', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1164561163', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000017', 'ABQ000017', 'NM01', 'ABQ Health Partners', 'Maher', '', 'Belmamoun', 'MD', 'Hospitalist', '', '', NULL, 'O', '500 Walter St NE Ste 401', 'Albuquerque', 'Bernalillo', 'NM', '87102', '5057278039', '5057278086', '500 Walter St NE Ste 401', 'Albuquerque', 'Bernalillo', 'NM', '87102', '5057278039', '5057278086', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1306847025', 0, 'N', 0, '2014-06-13', NULL, NULL, 35.0863, -106.64, NULL, NULL),
('204043287', 'ABQ000817', 'ABQ000817', 'NM01', 'ABQ Health Partners', 'Maher', '', 'Belmamoun', 'MD', 'Hospitalist', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5057278039', '5057278086', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5057278039', '5057278086', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1306847025', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000417', 'ABQ000417', 'NM01', 'ABQ Health Partners', 'Maher', '', 'Belmamoun', 'MD', 'Hospitalist', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5057278039', '5057278086', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5057278039', '5057278086', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1306847025', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000018', 'ABQ000018', 'NM01', 'ABQ Health Partners', 'Stanislav', '', 'Belyaev', 'MD', 'Pulmonary', '', '', NULL, 'O', '500 Walter St NE Ste 205', 'Albuquerque', 'Bernalillo', 'NM', '87102', '5052627223', '5052627450', '500 Walter St NE Ste 205', 'Albuquerque', 'Bernalillo', 'NM', '87102', '5052627223', '5052627450', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2012-06-15', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1659368207', 0, 'N', 0, '2012-07-05', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000818', 'ABQ000818', 'NM01', 'ABQ Health Partners', 'Stanislav', '', 'Belyaev', 'MD', 'Pulmonary', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052627223', '5052627450', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052627223', '5052627450', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2012-06-15', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1659368207', 0, 'N', 0, '2012-07-05', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000418', 'ABQ000418', 'NM01', 'ABQ Health Partners', 'Stanislav', '', 'Belyaev', 'MD', 'Pulmonary', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052627223', '5052627450', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052627223', '5052627450', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2012-06-15', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1659368207', 0, 'N', 0, '2012-07-05', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000019', 'ABQ000019', 'NM01', 'ABQ Health Partners', 'Tambra', '', 'Bensch', 'CNM', 'Obstetrics and Gynecology', '', '', NULL, 'O', '4705 Montgomery Blvd NE Ste 301-302', 'Albuquerque', 'Bernalillo', 'NM', '87109', '5052546500', '5052546532', '4705 Montgomery Blvd NE Ste 301-302', 'Albuquerque', 'Bernalillo', 'NM', '87109', '5052546500', '5052546532', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2013-09-03', 0, 0, 0, 'Lovelace Womens Hospital', 'Lovelace Westside Hospital', '', '', 'HCFA|UB|', '1528091014', 0, 'N', 0, '2014-06-24', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000819', 'ABQ000819', 'NM01', 'ABQ Health Partners', 'Tambra', '', 'Bensch', 'CNM', 'Obstetrics and Gynecology', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052546500', '5052546532', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052546500', '5052546532', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Womens Hospital', 'Lovelace Westside Hospital', '', '', 'HCFA|UB|', '1528091014', 0, 'N', 0, '2014-06-24', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000419', 'ABQ000419', 'NM01', 'ABQ Health Partners', 'Tambra', '', 'Bensch', 'CNM', 'Obstetrics and Gynecology', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052546500', '5052546532', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052546500', '5052546532', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Womens Hospital', 'Lovelace Westside Hospital', '', '', 'HCFA|UB|', '1528091014', 0, 'N', 0, '2014-06-24', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000021', 'ABQ000021', 'NM01', 'ABQ Health Partners', 'Brent', '', 'Bevard', 'DO', 'Pain Management', '', '', NULL, 'O', '10511 Golf Course Rd NW Ste 203', 'Albuquerque', 'Bernalillo', 'NM', '87114', '5052321150', '5052321151', '10511 Golf Course Rd NW Ste 203', 'Albuquerque', 'Bernalillo', 'NM', '87114', '5052321150', '5052321151', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1669486692', 0, 'N', 0, '2011-10-20', NULL, NULL, 35.2073, -106.676, NULL, NULL),
('830307918', 'W12013773', 'W12013773', 'WY01', 'Wortham Vision Care', 'Ross', 'C', 'Wortham', 'OD', 'Optometry', '', '', NULL, 'O', '106 S Main St', 'Lyman', 'Uinta', 'WY', '82937', '3077876123', '3077873351', '106 S Main St', 'Lyman', 'Uinta', 'WY', '82937', '3077876123', '3077873351', 'WYSTD', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2011-09-01', '2012-01-15', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1154571826', 0, 'N', 0, '2012-10-11', NULL, NULL, 0, 0, NULL, NULL),
('830307918', 'W12013775', 'W12013775', 'WY01', 'Wortham Vision Care', 'Ross', 'C', 'Wortham', 'OD', 'Optometry', '', '', NULL, 'B', 'PO Box 429', 'Lyman', 'Uinta', 'WY', '82937', '3077876123', '3077873351', 'PO Box 429', 'Lyman', 'Uinta', 'WY', '82937', '3077876123', '3077873351', 'WYSTD', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2011-09-01', '2012-01-15', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1154571826', 0, 'N', 0, '2012-10-11', NULL, NULL, 0, 0, NULL, NULL),
('830307918', 'W12013774', 'W12013774', 'WYT1', 'Wortham Vision Care', 'Ross', 'C', 'Wortham', 'OD', 'Optometry', '', '', NULL, 'O', '106 S Main St', 'Lyman', 'Uinta', 'WY', '82937', '3077876123', '3077873351', '106 S Main St', 'Lyman', 'Uinta', 'WY', '82937', '3077876123', '3077873351', 'WYSTD', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2011-09-01', '2012-01-15', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1154571826', 0, 'N', 0, '2012-10-11', NULL, NULL, 0, 0, NULL, NULL),
('830307918', 'W12013776', 'W12013776', 'WYT1', 'Wortham Vision Care', 'Ross', 'C', 'Wortham', 'OD', 'Optometry', '', '', NULL, 'B', 'PO Box 429', 'Lyman', 'Uinta', 'WY', '82937', '3077876123', '3077873351', 'PO Box 429', 'Lyman', 'Uinta', 'WY', '82937', '3077876123', '3077873351', 'WYSTD', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2011-09-01', '2012-01-15', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1154571826', 0, 'N', 0, '2012-10-11', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000820', 'ABQ000820', 'NM01', 'ABQ Health Partners', 'Brent', '', 'Bevard', 'DO', 'Pain Management', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052321150', '5052321151', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052321150', '5052321151', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1669486692', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000420', 'ABQ000420', 'NM01', 'ABQ Health Partners', 'Brent', '', 'Bevard', 'DO', 'Pain Management', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052321150', '5052321151', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052321150', '5052321151', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1669486692', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000025', 'ABQ000025', 'NM01', 'ABQ Health Partners', 'Tej', '', 'Bhavsar', 'MD', 'Urgent Care', '', '', NULL, 'O', '1721 Rio Rancho Blvd SE', 'Rio Rancho', 'Sandoval', 'NM', '87124', '5058968604', '5058968697', '1721 Rio Rancho Blvd SE', 'Rio Rancho', 'Sandoval', 'NM', '87124', '5058968604', '5058968697', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Womens Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1689725301', 0, 'Y', 0, '2012-01-17', NULL, NULL, 35.2284, -106.66, NULL, NULL),
('204043287', 'ABQ000822', 'ABQ000822', 'NM01', 'ABQ Health Partners', 'Tej', '', 'Bhavsar', 'MD', 'Urgent Care', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5058968604', '5058968697', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5058968604', '5058968697', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Womens Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1689725301', 0, 'Y', 0, '2012-01-17', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000422', 'ABQ000422', 'NM01', 'ABQ Health Partners', 'Tej', '', 'Bhavsar', 'MD', 'Urgent Care', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5058968604', '5058968697', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5058968604', '5058968697', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Womens Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1689725301', 0, 'N', 0, '2012-01-17', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000026', 'ABQ000026', 'NM01', 'ABQ Health Partners', 'William', '', 'Bigsby', 'OD', 'Optometry', '', '', NULL, 'O', '5150 Journal Ctr Blvd NE', 'Albuquerque', 'Bernalillo', 'NM', '87109', '5052623937', '5052623366', '5150 Journal Center Blvd NE', 'Albuquerque', 'Bernalillo', 'NM', '87109', '5052623937', '5052623366', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1902831993', 0, 'N', 0, '2011-10-20', NULL, NULL, 35.1702, -106.586, NULL, NULL),
('204043287', 'ABQ000826', 'ABQ000826', 'NM01', 'ABQ Health Partners', 'William', '', 'Bigsby', 'OD', 'Optometry', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052623937', '5052623366', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052623937', '5052623366', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1902831993', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000426', 'ABQ000426', 'NM01', 'ABQ Health Partners', 'William', '', 'Bigsby', 'OD', 'Optometry', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052623937', '5052623366', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052623937', '5052623366', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1902831993', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000027', 'ABQ000027', 'NM01', 'ABQ Health Partners', 'Pamela', '', 'Blair', 'CNP', 'Family Practice', 'Nurse Practitioner ', '', NULL, 'O', '500 Walter St NE Ste 301', 'Albuquerque', 'Bernalillo', 'NM', '87102', '5052623851', '5052627040', '500 Walter St NE Ste 301', 'Albuquerque', 'Bernalillo', 'NM', '87102', '5052623851', '5052627040', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1184851446', 0, 'Y', 0, '2013-12-31', NULL, NULL, 35.0863, -106.64, NULL, NULL),
('204043287', 'ABQ000827', 'ABQ000827', 'NM01', 'ABQ Health Partners', 'Pamela', '', 'Blair', 'CNP', 'Family Practice', 'Nurse Practitioner ', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052623851', '5052627040', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052623851', '5052627040', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1184851446', 0, 'N', 0, '2013-12-31', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000427', 'ABQ000427', 'NM01', 'ABQ Health Partners', 'Pamela', '', 'Blair', 'CNP', 'Family Practice', 'Nurse Practitioner ', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052623851', '5052627040', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052623851', '5052627040', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1184851446', 0, 'N', 0, '2013-12-31', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000028', 'ABQ000028', 'NM01', 'ABQ Health Partners', 'Shawn', '', 'Blaisdell', 'CNM', 'Obstetrics and Gynecology', '', '', NULL, 'O', '4705 Montgomery Blvd NE Ste 301-302', 'Albuquerque', 'Bernalillo', 'NM', '87109', '5052546500', '5052546532', '4705 Montgomery Blvd NE Ste 301-302', 'Albuquerque', 'Bernalillo', 'NM', '87109', '5052546500', '5052546532', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2012-01-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1083649065', 0, 'N', 0, '2012-01-17', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000828', 'ABQ000828', 'NM01', 'ABQ Health Partners', 'Shawn', '', 'Blaisdell', 'CNM', 'Obstetrics and Gynecology', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052546500', '5052546532', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052546500', '5052546532', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2012-01-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1083649065', 0, 'N', 0, '2012-01-17', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000428', 'ABQ000428', 'NM01', 'ABQ Health Partners', 'Shawn', '', 'Blaisdell', 'CNM', 'Obstetrics and Gynecology', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052546500', '5052546532', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052546500', '5052546532', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2012-01-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1083649065', 0, 'N', 0, '2012-01-17', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000829', 'ABQ000829', 'NM01', 'ABQ Health Partners', 'F. Adele', '', 'Blakely', 'MD', 'Pathology', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5057276450', '5057278391', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5057276450', '5057278391', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2013-01-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1952324238', 0, 'N', 0, '2013-01-25', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000029', 'ABQ000029', 'NM01', 'ABQ Health Partners', 'F. Adele', '', 'Blakely', 'MD', 'Pathology', '', '', NULL, 'O', '601 Dr Martin Luther King Jr Ave NE', 'Albuquerque', 'Bernalillo', 'NM', '87102', '5057276450', '5057278391', '601 Dr Martin Luther King Jr Ave NE', 'Albuquerque', 'Bernalillo', 'NM', '87102', '5057276450', '5057278391', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2013-01-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1952324238', 0, 'N', 0, '2013-01-25', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000429', 'ABQ000429', 'NM01', 'ABQ Health Partners', 'F. Adele', '', 'Blakely', 'MD', 'Pathology', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5057276450', '5057278391', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5057276450', '5057278391', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2013-01-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1952324238', 0, 'N', 0, '2013-01-25', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000030', 'ABQ000030', 'NM01', 'ABQ Health Partners', 'Janet', '', 'Blanchard', 'MD', 'Hospitalist', '', '', NULL, 'O', '500 Walter St NE Ste 309', 'Albuquerque', 'Bernalillo', 'NM', '87102', '5057278039', '5057278086', '500 Walter St NE Ste 309', 'Albuquerque', 'Bernalillo', 'NM', '87102', '5057278039', '5057278086', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2013-02-15', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1134213507', 0, 'N', 0, '2013-02-22', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000830', 'ABQ000830', 'NM01', 'ABQ Health Partners', 'Janet', '', 'Blanchard', 'MD', 'Hospitalist', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5057278039', '5057278086', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5057278039', '5057278086', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2013-02-15', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1134213507', 0, 'N', 0, '2013-02-22', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000430', 'ABQ000430', 'NM01', 'ABQ Health Partners', 'Janet', '', 'Blanchard', 'MD', 'Hospitalist', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5057278039', '5057278086', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5057278039', '5057278086', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2013-02-15', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1134213507', 0, 'N', 0, '2013-02-22', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000031', 'ABQ000031', 'NM01', 'ABQ Health Partners', 'Andrea', '', 'Bliss', 'PA-C', 'Internal Medicine', '', '', NULL, 'O', '5150 Journal Ctr Blvd NE', 'Albuquerque', 'Bernalillo', 'NM', '87109', '5052623212', '5052623381', '5150 Journal Center Blvd NE', 'Albuquerque', 'Bernalillo', 'NM', '87109', '5052623212', '5052623381', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1760499701', 0, 'N', 0, '2012-05-24', NULL, NULL, 35.1702, -106.586, NULL, NULL),
('204043287', 'ABQ000831', 'ABQ000831', 'NM01', 'ABQ Health Partners', 'Andrea', '', 'Bliss', 'PA-C', 'Internal Medicine', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052623212', '5052623381', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052623212', '5052623381', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1760499701', 0, 'N', 0, '2012-05-24', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000431', 'ABQ000431', 'NM01', 'ABQ Health Partners', 'Andrea', '', 'Bliss', 'PA-C', 'Internal Medicine', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052623212', '5052623381', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052623212', '5052623381', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1760499701', 0, 'N', 0, '2012-05-24', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000370', 'ABQ000370', 'NM01', 'ABQ Health Partners', 'Jennifer', '', 'Zeer', 'CNM', 'Obstetrics and Gynecology', '', '', NULL, 'O', '4705 Montgomery Blvd NE Ste 301-302', 'Albuquerque', 'Bernalillo', 'NM', '87109', '5052546500', '5052546532', '4705 Montgomery Blvd NE Ste 301-302', 'Albuquerque', 'Bernalillo', 'NM', '87109', '5052546500', '5052546532', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2012-02-29', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1659603579', 0, 'N', 0, '2012-03-19', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ001170', 'ABQ001170', 'NM01', 'ABQ Health Partners', 'Jennifer', '', 'Zeer', 'CNM', 'Obstetrics and Gynecology', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052546500', '5052546532', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052546500', '5052546532', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2012-02-29', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1659603579', 0, 'N', 0, '2012-03-19', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000770', 'ABQ000770', 'NM01', 'ABQ Health Partners', 'Jennifer', '', 'Zeer', 'CNM', 'Obstetrics and Gynecology', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052546500', '5052546532', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052546500', '5052546532', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2012-02-29', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1659603579', 0, 'N', 0, '2012-03-19', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000369', 'ABQ000369', 'NM01', 'ABQ Health Partners', 'Yeni', '', 'Yim', 'CNM', 'Obstetrics and Gynecology', '', '', NULL, 'O', '4705 Montgomery Blvd NE Ste 301-302', 'Albuquerque', 'Bernalillo', 'NM', '87109', '5052546500', '5052546532', '4705 Montgomery Blvd NE Ste 301-302', 'Albuquerque', 'Bernalillo', 'NM', '87109', '5052546500', '5052546532', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2013-09-03', 0, 0, 0, 'Lovelace Medical Center', 'Lovelace Womens Hospital', '', '', 'HCFA|UB|', '1215960711', 0, 'N', 0, '2014-06-24', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ001168', 'ABQ001168', 'NM01', 'ABQ Health Partners', 'Yeni', '', 'Yim', 'CNM', 'Obstetrics and Gynecology', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052546500', '5052546532', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052546500', '5052546532', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Medical Center', 'Lovelace Womens Hospital', '', '', 'HCFA|UB|', '1215960711', 0, 'N', 0, '2014-06-24', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000768', 'ABQ000768', 'NM01', 'ABQ Health Partners', 'Yeni', '', 'Yim', 'CNM', 'Obstetrics and Gynecology', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052546500', '5052546532', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052546500', '5052546532', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Medical Center', 'Lovelace Womens Hospital', '', '', 'HCFA|UB|', '1215960711', 0, 'N', 0, '2014-06-24', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000032', 'ABQ000032', 'NM01', 'ABQ Health Partners', 'Carla', '', 'Bloedel-Clark', 'MD', 'Pediatrics', '', '', NULL, 'O', '5150 Journal Ctr Blvd NE', 'Albuquerque', 'Bernalillo', 'NM', '87109', '5052623219', '5052623243', '5150 Journal Center Blvd NE', 'Albuquerque', 'Bernalillo', 'NM', '87109', '5052623219', '5052623243', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Womens Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1093748667', 0, 'N', 0, '2011-10-20', NULL, NULL, 35.1702, -106.586, NULL, NULL),
('204043287', 'ABQ000832', 'ABQ000832', 'NM01', 'ABQ Health Partners', 'Carla', '', 'Bloedel-Clark', 'MD', 'Pediatrics', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052623219', '5052623243', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052623219', '5052623243', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Womens Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1093748667', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000432', 'ABQ000432', 'NM01', 'ABQ Health Partners', 'Carla', '', 'Bloedel-Clark', 'MD', 'Pediatrics', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052623219', '5052623243', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052623219', '5052623243', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Womens Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1093748667', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000036', 'ABQ000036', 'NM01', 'ABQ Health Partners', 'Meghan', '', 'Blum Linden', 'PA-C', 'Urgent Care', '', '', NULL, 'O', '9101 Montgomery Blvd NE', 'Albuquerque', 'Bernalillo', 'NM', '87111', '5052754259', '5052754223', '9101 Montgomery Blvd NE', 'Albuquerque', 'Bernalillo', 'NM', '87111', '5052754259', '5052754223', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2014-05-15', 0, 0, 0, 'Lovelace Womens Hospital', '', '', '', 'HCFA|UB|', '1033424676', 0, 'Y', 0, '2014-05-27', NULL, NULL, 35.1307, -106.542, NULL, NULL),
('204043287', 'ABQ000833', 'ABQ000833', 'NM01', 'ABQ Health Partners', 'Meghan', '', 'Blum Linden', 'PA-C', 'Urgent Care', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5058968604', '5058968697', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5058968604', '5058968697', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2014-05-15', 0, 0, 0, 'Lovelace Womens Hospital', '', '', '', 'HCFA|UB|', '1033424676', 0, 'Y', 0, '2014-05-27', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000433', 'ABQ000433', 'NM01', 'ABQ Health Partners', 'Meghan', '', 'Blum Linden', 'PA-C', 'Urgent Care', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5058968604', '5058968697', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5058968604', '5058968697', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2014-05-15', 0, 0, 0, 'Lovelace Womens Hospital', '', '', '', 'HCFA|UB|', '1033424676', 0, 'N', 0, '2014-05-27', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ001167', 'ABQ001167', 'NM01', 'ABQ Health Partners', 'Peter', '', 'Wong', 'MD', 'Family Practice', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052754288', '5052754203', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052754288', '5052754203', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1427071521', 0, 'N', 0, '2014-07-18', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000367', 'ABQ000367', 'NM01', 'ABQ Health Partners', 'Peter', '', 'Wong', 'MD', 'Family Practice', '', '', NULL, 'O', '9101 Montgomery Blvd NE', 'Albuquerque', 'Bernalillo', 'NM', '87111', '5052754288', '5052754203', '9101 Montgomery Blvd NE', 'Albuquerque', 'Bernalillo', 'NM', '87111', '5052754288', '5052754203', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2014-07-15', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1427071521', 0, 'N', 0, '2014-07-18', NULL, NULL, 35.1307, -106.542, NULL, NULL),
('204043287', 'ABQ000767', 'ABQ000767', 'NM01', 'ABQ Health Partners', 'Peter', '', 'Wong', 'MD', 'Family Practice', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052754288', '5052754203', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052754288', '5052754203', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1427071521', 0, 'N', 0, '2014-07-18', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000039', 'ABQ000039', 'NM01', 'ABQ Health Partners', 'David', '', 'Brown', 'MD', 'Family Practice', '', '', NULL, 'O', '2929 Coors Blvd NW Ste 200', 'Albuquerque', 'Bernalillo', 'NM', '87120', '5058392300', '5058392303', '2929 Coors Blvd NW Ste 200', 'Albuquerque', 'Bernalillo', 'NM', '87120', '5058392300', '5058392303', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Westside Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1427083617', 0, 'N', 0, '2011-10-20', NULL, NULL, 35.1168, -106.702, NULL, NULL),
('204043287', 'ABQ000839', 'ABQ000839', 'NM01', 'ABQ Health Partners', 'David', '', 'Brown', 'MD', 'Family Practice', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5058392300', '5058392303', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5058392300', '5058392303', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Westside Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1427083617', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000439', 'ABQ000439', 'NM01', 'ABQ Health Partners', 'David', '', 'Brown', 'MD', 'Family Practice', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5058392300', '5058392303', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5058392300', '5058392303', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Westside Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1427083617', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000040', 'ABQ000040', 'NM01', 'ABQ Health Partners', 'James', '', 'Brown', 'MD', 'Family Practice', '', '', NULL, 'O', '13701 Encantado Rd NE', 'Albuquerque', 'Bernalillo', 'NM', '87123', '5052378700', '5052378703', '13701 Encantado Rd NE', 'Albuquerque', 'Bernalillo', 'NM', '87123', '5052378700', '5052378703', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2013-01-11', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1497849863', 0, 'N', 0, '2013-02-06', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000840', 'ABQ000840', 'NM01', 'ABQ Health Partners', 'James', '', 'Brown', 'MD', 'Family Practice', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052378700', '5052378703', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052378700', '5052378703', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2013-01-11', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1497849863', 0, 'N', 0, '2013-02-06', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000440', 'ABQ000440', 'NM01', 'ABQ Health Partners', 'James', '', 'Brown', 'MD', 'Family Practice', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052378700', '5052378703', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052378700', '5052378703', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2013-01-11', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1497849863', 0, 'N', 0, '2013-02-06', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000366', 'ABQ000366', 'NM01', 'ABQ Health Partners', 'Matthew', '', 'Wilson', 'PA-C', 'Hospitalist', '', '', NULL, 'O', '500 Walter St NE Ste 401', 'Albuquerque', 'Bernalillo', 'NM', '87102', '5057278039', '5057278086', '500 Walter St NE Ste 401', 'Albuquerque', 'Bernalillo', 'NM', '87102', '5057278039', '5057278086', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Medical Center', 'Lovelace Womens Hospital', 'Lovelace Westside Hospital ', NULL, 'HCFA|UB|', '1407088206', 0, 'N', 0, '2014-06-13', NULL, NULL, 35.0863, -106.64, NULL, NULL),
('204043287', 'ABQ001166', 'ABQ001166', 'NM01', 'ABQ Health Partners', 'Matthew', '', 'Wilson', 'PA-C', 'Hospitalist', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5057278039', '5057278086', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5057278039', '5057278086', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Medical Center', 'Lovelace Womens Hospital', 'Lovelace Westside Hospital ', NULL, 'HCFA|UB|', '1407088206', 0, 'N', 0, '2012-05-25', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000766', 'ABQ000766', 'NM01', 'ABQ Health Partners', 'Matthew', '', 'Wilson', 'PA-C', 'Hospitalist', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5057278039', '5057278086', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5057278039', '5057278086', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Medical Center', 'Lovelace Womens Hospital', 'Lovelace Westside Hospital ', NULL, 'HCFA|UB|', '1407088206', 0, 'N', 0, '2012-05-25', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000044', 'ABQ000044', 'NM01', 'ABQ Health Partners', 'Dennis', '', 'Burkett', 'MD', 'Urgent Care', '', '', NULL, 'O', '5150 Journal Ctr Blvd NE', 'Albuquerque', 'Bernalillo', 'NM', '87109', '5052623233', '5052623191', '5150 Journal Center Blvd NE', 'Albuquerque', 'Bernalillo', 'NM', '87109', '5052623233', '5052623191', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1376598722', 0, 'Y', 0, '2012-01-17', NULL, NULL, 35.1702, -106.586, NULL, NULL),
('204043287', 'ABQ000841', 'ABQ000841', 'NM01', 'ABQ Health Partners', 'Dennis', '', 'Burkett', 'MD', 'Urgent Care', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5058968604', '5058968697', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5058968604', '5058968697', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1376598722', 0, 'Y', 0, '2012-01-17', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000441', 'ABQ000441', 'NM01', 'ABQ Health Partners', 'Dennis', '', 'Burkett', 'MD', 'Urgent Care', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5058968604', '5058968697', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5058968604', '5058968697', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1376598722', 0, 'N', 0, '2012-01-17', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000045', 'ABQ000045', 'NM01', 'ABQ Health Partners', 'Jacqueline', '', 'Burkett', 'CNM', 'Obstetrics and Gynecology', '', '', NULL, 'O', '4705 Montgomery Blvd NE Ste 301-302', 'Albuquerque', 'Bernalillo', 'NM', '87109', '5052546500', '5052546532', '4705 Montgomery Blvd NE Ste 301-302', 'Albuquerque', 'Bernalillo', 'NM', '87109', '5052546500', '5052546532', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Womens Hospital', 'Lovelace Westside Hospital', NULL, NULL, 'HCFA|UB|', '1528149598', 0, 'N', 0, '2011-10-20', NULL, NULL, 35.131, -106.591, NULL, NULL),
('204043287', 'ABQ000845', 'ABQ000845', 'NM01', 'ABQ Health Partners', 'Jacqueline', '', 'Burkett', 'CNM', 'Obstetrics and Gynecology', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052546500', '5052546532', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052546500', '5052546532', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Womens Hospital', 'Lovelace Westside Hospital', NULL, NULL, 'HCFA|UB|', '1528149598', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000445', 'ABQ000445', 'NM01', 'ABQ Health Partners', 'Jacqueline', '', 'Burkett', 'CNM', 'Obstetrics and Gynecology', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052546500', '5052546532', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052546500', '5052546532', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Womens Hospital', 'Lovelace Westside Hospital', NULL, NULL, 'HCFA|UB|', '1528149598', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000846', 'ABQ000846', 'NM01', 'ABQ Health Partners', 'Kristen', '', 'Bushnell', 'PA-C', 'General Surgery', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052627281', '5052627622', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052627281', '5052627622', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Westside Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1982818860', 0, 'N', 0, '2013-10-03', NULL, NULL, 0, 0, NULL, NULL);
INSERT INTO `providers_new` (`Provider_Tax_ID`, `Provider_Suffix`, `Provider_Network_ID`, `Provider_Region`, `Provider_Name`, `Provider_Doctor_First_Name`, `Provider_Doctor_Middle_Name`, `Provider_Doctor_Last_Name`, `Provider_Doctor_Degree`, `Provider_Specialty_1`, `Provider_Specialty_2`, `Provider_Specialty_3`, `Provider_Specialty_4`, `Provider_Address_Type`, `Provider_Address`, `Provider_City`, `Provider_County`, `Provider_State`, `Provider_Zip`, `Provider_Phone`, `Provider_Fax`, `Provider_Mailing_Address`, `Provider_Mailing_City`, `Provider_Mailing_County`, `Provider_Mailing_State`, `Provider_Mailing_Zip`, `Provider_Mailing_Phone`, `Provider_Mailing_Fax`, `Provider_Primary_Schedule`, `Provider_Secondary_Schedule`, `Provider_Rate_Sheet`, `Provider_Anes_Rate`, `Provider_Default_Rate`, `Provider_Max_DOS`, `Provider_Min_Match_Value`, `Provider_Effective_Date`, `Provider_Term_Date`, `Provider_Pend`, `Provider_Anes_Minutes`, `Provider_PPO`, `Provider_Hospital_1`, `Provider_Hospital_2`, `Provider_Hospital_3`, `Provider_Hospital_4`, `Provider_Type`, `Provider_NPI`, `Provider_Check_Override`, `Exclude_Dir`, `Audit_Status`, `Last_Change_Date`, `Medicare_ID`, `Provider_Lang`, `Provider_Latitude`, `Provider_Longitude`, `Provider_school`, `Provider_cert`) VALUES
('204043287', 'ABQ000046', 'ABQ000046', 'NM01', 'ABQ Health Partners', 'Kristen', '', 'Bushnell', 'PA-C', 'General Surgery', '', '', NULL, 'O', '715 Dr Martin Luther King Jr Ave NE Ste 301', 'Albuquerque', 'Bernalillo', 'NM', '87102', '5052627281', '5052627622', '715 Dr Martin Luther King Jr Ave NE Ste 301', 'Albuquerque', 'Bernalillo', 'NM', '87102', '5052627281', '5052627622', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Westside Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1982818860', 0, 'N', 0, '2013-10-03', NULL, NULL, 35.0856, -106.639, NULL, NULL),
('204043287', 'ABQ000446', 'ABQ000446', 'NM01', 'ABQ Health Partners', 'Kristen', '', 'Bushnell', 'PA-C', 'General Surgery', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052627281', '5052627622', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052627281', '5052627622', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Westside Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1982818860', 0, 'N', 0, '2013-10-03', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000050', 'ABQ000050', 'NM01', 'ABQ Health Partners', 'Doug', '', 'Calfrobe', 'PA-C', 'Urgent Care', '', '', NULL, 'O', '200 Rio Bravo Blvd SE', 'Albuquerque', 'Bernalillo', 'NM', '87105', '5058736401', '5058736408', '200 Rio Bravo Blvd SE', 'Albuquerque', 'Bernalillo', 'NM', '87105', '5058736401', '5058736408', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2012-01-01', 0, 0, 0, 'Lovelace Womens Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1780622985', 0, 'Y', 0, '2012-01-17', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000847', 'ABQ000847', 'NM01', 'ABQ Health Partners', 'Doug', '', 'Calfrobe', 'PA-C', 'Urgent Care', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5058968604', '5058968697', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5058968604', '5058968697', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Womens Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1780622985', 0, 'Y', 0, '2012-01-17', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000447', 'ABQ000447', 'NM01', 'ABQ Health Partners', 'Doug', '', 'Calfrobe', 'PA-C', 'Urgent Care', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5058968604', '5058968697', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5058968604', '5058968697', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Womens Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1780622985', 0, 'N', 0, '2012-01-17', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000365', 'ABQ000365', 'NM01', 'ABQ Health Partners', 'Jennifer', '', 'Williams', 'CNM', 'Obstetrics and Gynecology', '', '', NULL, 'O', '5400 Gibson Blvd SE', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052546500', '5052546532', '5400 Gibson Blvd SE', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052546500', '5052546532', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Medical Center', '', '', '', 'HCFA|UB|', '1043245020', 0, 'N', 0, '2014-06-24', NULL, NULL, 35.0583, -106.582, NULL, NULL),
('204043287', 'ABQ000765', 'ABQ000765', 'NM01', 'ABQ Health Partners', 'Jennifer', '', 'Williams', 'CNM', 'Obstetrics and Gynecology', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052546500', '5052546532', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052546500', '5052546532', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Medical Center', '', '', '', 'HCFA|UB|', '1043245020', 0, 'N', 0, '2014-06-24', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000051', 'ABQ000051', 'NM01', 'ABQ Health Partners', 'Tatiana', '', 'Canning', 'MD', 'Hospitalist', '', '', NULL, 'O', '500 Walter St NE Ste 309', 'Albuquerque', 'Bernalillo', 'NM', '87102', '5057278039', '5057278086', '500 Walter St NE Ste 309', 'Albuquerque', 'Bernalillo', 'NM', '87102', '5057278039', '5057278086', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2014-02-12', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1245263730', 0, 'N', 0, '2014-03-13', NULL, NULL, 35.0863, -106.64, NULL, NULL),
('204043287', 'ABQ000851', 'ABQ000851', 'NM01', 'ABQ Health Partners', 'Tatiana', '', 'Canning', 'MD', 'Hospitalist', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5057278039', '5057278086', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5057278039', '5057278086', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2014-02-12', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1245263730', 0, 'N', 0, '2014-03-13', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000451', 'ABQ000451', 'NM01', 'ABQ Health Partners', 'Tatiana', '', 'Canning', 'MD', 'Hospitalist', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5057278039', '5057278086', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5057278039', '5057278086', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2014-02-12', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1245263730', 0, 'N', 0, '2014-03-13', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000364', 'ABQ000364', 'NM01', 'ABQ Health Partners', 'Robert', '', 'White', 'MD', 'Urgent Care', '', '', NULL, 'O', '1721 Rio Rancho Blvd SE', 'Rio Rancho', 'Sandoval', 'NM', '87124', '5058968604', '5058968697', '1721 Rio Rancho Blvd SE', 'Rio Rancho', 'Sandoval', 'NM', '87124', '5058968604', '5058968697', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1962412775', 0, 'Y', 0, '2012-01-17', NULL, NULL, 35.2284, -106.66, NULL, NULL),
('204043287', 'ABQ001161', 'ABQ001161', 'NM01', 'ABQ Health Partners', 'Robert', '', 'White', 'MD', 'Urgent Care', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5058968604', '5058968697', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5058968604', '5058968697', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1962412775', 0, 'N', 0, '2012-01-17', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000761', 'ABQ000761', 'NM01', 'ABQ Health Partners', 'Robert', '', 'White', 'MD', 'Urgent Care', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5058968604', '5058968697', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5058968604', '5058968697', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1962412775', 0, 'N', 0, '2012-01-17', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000052', 'ABQ000052', 'NM01', 'ABQ Health Partners', 'Patricia', '', 'Carabajal', 'MD', 'Family Practice', '', '', NULL, 'O', '2121 Juan Tabo Blvd NE', 'Albuquerque', 'Bernalillo', 'NM', '87112', '5052378800', '5052378817', '2121 Juan Tabo Blvd NE', 'Albuquerque', 'Bernalillo', 'NM', '87112', '5052378800', '5052378817', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1255366274', 0, 'N', 0, '2012-06-13', NULL, NULL, 35.1062, -106.516, NULL, NULL),
('204043287', 'ABQ000852', 'ABQ000852', 'NM01', 'ABQ Health Partners', 'Patricia', '', 'Carabajal', 'MD', 'Family Practice', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052378800', '5052378817', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052378800', '5052378817', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1255366274', 0, 'N', 0, '2012-06-13', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000452', 'ABQ000452', 'NM01', 'ABQ Health Partners', 'Patricia', '', 'Carabajal', 'MD', 'Family Practice', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052378800', '5052378817', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052378800', '5052378817', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1255366274', 0, 'N', 0, '2012-06-13', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000038', 'ABQ000038', 'NM01', 'ABQ Health Partners', 'Richard', '', 'Brewer', 'MD', 'Family Practice', '', '', NULL, 'O', '5150 Journal Ctr Blvd NE', 'Albuquerque', 'Bernalillo', 'NM', '87109', '5052623212', '5052623381', '5150 Journal Ctr Blvd NE', 'Albuquerque', 'Bernalillo', 'NM', '87109', '5052623212', '5052623381', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2012-10-16', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1164457347', 0, 'N', 0, '2012-12-26', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000838', 'ABQ000838', 'NM01', 'ABQ Health Partners', 'Richard', '', 'Brewer', 'MD', 'Family Practice', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052623212', '5052623381', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052623212', '5052623381', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2012-10-16', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1164457347', 0, 'N', 0, '2012-12-26', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000438', 'ABQ000438', 'NM01', 'ABQ Health Partners', 'Richard', '', 'Brewer', 'MD', 'Family Practice', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052623212', '5052623381', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052623212', '5052623381', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2012-10-16', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1164457347', 0, 'N', 0, '2012-12-26', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000360', 'ABQ000360', 'NM01', 'ABQ Health Partners', 'Thomas', '', 'Whigham', 'MD', 'Gastroenterology', '', '', NULL, 'O', '5400 Gibson Blvd SE', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052627174', '5052623562', '5400 Gibson Blvd SE', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052627174', '5052623562', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Westside Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1619902715', 0, 'N', 0, '2013-09-24', NULL, NULL, 35.0583, -106.582, NULL, NULL),
('204043287', 'ABQ000760', 'ABQ000760', 'NM01', 'ABQ Health Partners', 'Thomas', '', 'Whigham', 'MD', 'Gastroenterology', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052627600', '0000000000', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052627600', '0000000000', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Westside Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1619902715', 0, 'N', 0, '2013-09-24', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000053', 'ABQ000053', 'NM01', 'ABQ Health Partners', 'Siri', '', 'Casey', 'CDE', 'Diabetic Education', '', '', NULL, 'O', '5400 Gibson Blvd SE', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052627455', '5052623955', '5400 Gibson Blvd SE', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052627455', '5052623955', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1144243437', 0, 'N', 0, '2013-09-09', NULL, NULL, 35.0583, -106.582, NULL, NULL),
('204043287', 'ABQ000453', 'ABQ000453', 'NM01', 'ABQ Health Partners', 'Siri', '', 'Casey', 'CDE', 'Diabetic Education', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052627455', '5052623955', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052627455', '5052623955', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1144243437', 0, 'N', 0, '2013-09-09', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000054', 'ABQ000054', 'NM01', 'ABQ Health Partners', 'Terri', '', 'Caspary-Schmidt', 'CNM', 'Obstetrics and Gynecology', '', '', NULL, 'O', '4705 Montgomery Blvd NE Ste 301-302', 'Albuquerque', 'Bernalillo', 'NM', '87109', '5052546500', '5052546532', '4705 Montgomery Blvd NE Ste 301-302', 'Albuquerque', 'Bernalillo', 'NM', '87109', '5052546500', '5052546532', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2013-09-03', 0, 0, 0, 'Lovelace Womens Hospital', 'Lovelace Westside Hospital', '', '', 'HCFA|UB|', '1396778981', 0, 'N', 0, '2014-06-24', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000854', 'ABQ000854', 'NM01', 'ABQ Health Partners', 'Terri', '', 'Caspary-Schmidt', 'CNM', 'Obstetrics and Gynecology', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052546500', '5052546532', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052546500', '5052546532', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Womens Hospital', 'Lovelace Westside Hospital', '', '', 'HCFA|UB|', '1396778981', 0, 'N', 0, '2014-06-24', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000454', 'ABQ000454', 'NM01', 'ABQ Health Partners', 'Terri', '', 'Caspary-Schmidt', 'CNM', 'Obstetrics and Gynecology', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052546500', '5052546532', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052546500', '5052546532', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Womens Hospital', 'Lovelace Westside Hospital', '', '', 'HCFA|UB|', '1396778981', 0, 'N', 0, '2014-06-24', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000055', 'ABQ000055', 'NM01', 'ABQ Health Partners', 'Clare', '', 'Castiglia', 'DO', 'Internal Medicine', '', '', NULL, 'O', '3901 Carlisle Blvd NE', 'Albuquerque', 'Bernalillo', 'NM', '87107', '5058888500', '5058888503', '3901 Carlisle Blvd NE', 'Albuquerque', 'Bernalillo', 'NM', '87107', '5058888500', '5058888503', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1992730675', 0, 'N', 0, '2011-10-20', NULL, NULL, 35.1252, -106.604, NULL, NULL),
('204043287', 'ABQ000855', 'ABQ000855', 'NM01', 'ABQ Health Partners', 'Clare', '', 'Castiglia', 'DO', 'Internal Medicine', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5058888500', '5058888503', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5058888500', '5058888503', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1992730675', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000455', 'ABQ000455', 'NM01', 'ABQ Health Partners', 'Clare', '', 'Castiglia', 'DO', 'Internal Medicine', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5058888500', '5058888503', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5058888500', '5058888503', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1992730675', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000056', 'ABQ000056', 'NM01', 'ABQ Health Partners', 'Caroline', '', 'Castillo', 'MD', 'Hospitalist', '', '', NULL, 'O', '500 Walter St NE Ste 401', 'Albuquerque', 'Bernalillo', 'NM', '87102', '5057278039', '5057278086', '500 Walter St NE Ste 401', 'Albuquerque', 'Bernalillo', 'NM', '87102', '5057278039', '5057278086', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Medical Center', 'Lovelace Westside Hospital', NULL, NULL, 'HCFA|UB|', '1467413153', 0, 'N', 0, '2014-06-13', NULL, NULL, 35.0863, -106.64, NULL, NULL),
('204043287', 'ABQ000856', 'ABQ000856', 'NM01', 'ABQ Health Partners', 'Caroline', '', 'Castillo', 'MD', 'Hospitalist', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5057278039', '5057278086', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5057278039', '5057278086', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Medical Center', 'Lovelace Westside Hospital', NULL, NULL, 'HCFA|UB|', '1467413153', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000456', 'ABQ000456', 'NM01', 'ABQ Health Partners', 'Caroline', '', 'Castillo', 'MD', 'Hospitalist', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5057278039', '5057278086', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5057278039', '5057278086', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Medical Center', 'Lovelace Westside Hospital', NULL, NULL, 'HCFA|UB|', '1467413153', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000058', 'ABQ000058', 'NM01', 'ABQ Health Partners', 'Yvonne', '', 'Castillo', 'CNM', 'Obstetrics and Gynecology', '', '', NULL, 'O', '5400 Gibson Blvd SE', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052546500', '5052546532', '5400 Gibson Blvd SE', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052546500', '5052546532', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Medical Center', '', '', '', 'HCFA|UB|', '1396778809', 0, 'N', 0, '2014-06-24', NULL, NULL, 35.0583, -106.582, NULL, NULL),
('204043287', 'ABQ000457', 'ABQ000457', 'NM01', 'ABQ Health Partners', 'Yvonne', '', 'Castillo', 'CNM', 'Obstetrics and Gynecology', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052546500', '5052546532', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052546500', '5052546532', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Medical Center', '', '', '', 'HCFA|UB|', '1396778809', 0, 'N', 0, '2014-06-24', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000859', 'ABQ000859', 'NM01', 'ABQ Health Partners', 'Barbara', '', 'Cechanowicz', 'PA-C', 'General Surgery', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052627281', '5052627622', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052627281', '5052627622', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2012-01-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1588758957', 0, 'N', 0, '2012-01-17', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000059', 'ABQ000059', 'NM01', 'ABQ Health Partners', 'Barbara', '', 'Cechanowicz', 'PA-C', 'General Surgery', '', '', NULL, 'O', '715 Dr Martin Luther King Jr Ave NE Ste 301', 'Albuquerque', 'Bernalillo', 'NM', '87102', '5052627281', '5052627622', '715 Dr Martin Luther King Jr Ave NE Ste 301', 'Albuquerque', 'Bernalillo', 'NM', '87102', '5052627281', '5052627622', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2012-01-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1588758957', 0, 'N', 0, '2012-01-17', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000459', 'ABQ000459', 'NM01', 'ABQ Health Partners', 'Barbara', '', 'Cechanowicz', 'PA-C', 'General Surgery', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052627281', '5052627622', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052627281', '5052627622', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2012-01-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1588758957', 0, 'N', 0, '2012-01-17', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000060', 'ABQ000060', 'NM01', 'ABQ Health Partners', 'Pamela', '', 'Chapman', 'MD', 'Pediatrics', '', '', NULL, 'O', '5400 Gibson Blvd SE', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052627594', '5052627641', '5400 Gibson Blvd SE', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052627594', '5052627641', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1417062373', 0, 'N', 0, '2011-10-20', NULL, NULL, 35.0583, -106.582, NULL, NULL),
('204043287', 'ABQ000460', 'ABQ000460', 'NM01', 'ABQ Health Partners', 'Pamela', '', 'Chapman', 'MD', 'Pediatrics', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052627594', '5052627641', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052627594', '5052627641', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1417062373', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000061', 'ABQ000061', 'NM01', 'ABQ Health Partners', 'Alice', '', 'Chavez', 'MD', 'Obstetrics and Gynecology', '', '', NULL, 'O', '5150 Journal Ctr Blvd NE', 'Albuquerque', 'Bernalillo', 'NM', '87109', '5052546500', '5052623198', '5150 Journal Center Blvd NE', 'Albuquerque', 'Bernalillo', 'NM', '87109', '5052546500', '5052623198', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Womens Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1497788996', 0, 'N', 0, '2011-10-20', NULL, NULL, 35.1702, -106.586, NULL, NULL),
('204043287', 'ABQ000861', 'ABQ000861', 'NM01', 'ABQ Health Partners', 'Alice', '', 'Chavez', 'MD', 'Obstetrics and Gynecology', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052546500', '5052623198', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052546500', '5052623198', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Womens Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1497788996', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000461', 'ABQ000461', 'NM01', 'ABQ Health Partners', 'Alice', '', 'Chavez', 'MD', 'Obstetrics and Gynecology', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052546500', '5052623198', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052546500', '5052623198', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Womens Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1497788996', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000062', 'ABQ000062', 'NM01', 'ABQ Health Partners', 'Carol', '', 'Chavez', 'PA-C', 'Sleep Medicine', '', '', NULL, 'O', '4700 Jefferson St NE Ste 800', 'Albuquerque', 'Bernalillo', 'NM', '87109', '5058726000', '5058726003', '4700 Jefferson St NE Ste 800', 'Albuquerque', 'Bernalillo', 'NM', '87109', '5058726000', '5058726003', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1871703405', 0, 'N', 0, '2011-10-20', NULL, NULL, 35.1342, -106.593, NULL, NULL),
('204043287', 'ABQ000862', 'ABQ000862', 'NM01', 'ABQ Health Partners', 'Carol', '', 'Chavez', 'PA-C', 'Sleep Medicine', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5058726000', '5058726003', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5058726000', '5058726003', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1871703405', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000462', 'ABQ000462', 'NM01', 'ABQ Health Partners', 'Carol', '', 'Chavez', 'PA-C', 'Sleep Medicine', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5058726000', '5058726003', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5058726000', '5058726003', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1871703405', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000063', 'ABQ000063', 'NM01', 'ABQ Health Partners', 'Gary', '', 'Chavez', 'PA-C', 'Orthopedic Surgery', '', '', NULL, 'O', '5150 Journal Ctr Blvd NE', 'Albuquerque', 'Bernalillo', 'NM', '87109', '5053428400', '5053428401', '5150 Journal Center Blvd NE', 'Albuquerque', 'Bernalillo', 'NM', '87109', '5053428400', '5053428401', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Womens Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1073599270', 0, 'N', 0, '2011-10-20', NULL, NULL, 35.1702, -106.586, NULL, NULL),
('204043287', 'ABQ000863', 'ABQ000863', 'NM01', 'ABQ Health Partners', 'Gary', '', 'Chavez', 'PA-C', 'Orthopedic Surgery', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5053428400', '5053428401', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5053428400', '5053428401', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Womens Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1073599270', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000463', 'ABQ000463', 'NM01', 'ABQ Health Partners', 'Gary', '', 'Chavez', 'PA-C', 'Orthopedic Surgery', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5053428400', '5053428401', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5053428400', '5053428401', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Womens Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1073599270', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000064', 'ABQ000064', 'NM01', 'ABQ Health Partners', 'Edward', '', 'Chelist', 'MD', 'Family Practice', 'Urgent Care', '', NULL, 'O', '1721 Rio Rancho Blvd SE', 'Rio Rancho', 'Sandoval', 'NM', '87124', '5058968604', '5058968697', '1721 Rio Rancho Blvd SE', 'Rio Rancho', 'Sandoval', 'NM', '87124', '5058968604', '5058968697', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2012-08-27', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1760535074', 0, 'N', 0, '2012-09-07', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000864', 'ABQ000864', 'NM01', 'ABQ Health Partners', 'Edward', '', 'Chelist', 'MD', 'Family Practice', 'Urgent Care', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5058968600', '5058968618', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5058968600', '5058968618', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2012-08-27', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1760535074', 0, 'N', 0, '2012-09-07', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000464', 'ABQ000464', 'NM01', 'ABQ Health Partners', 'Edward', '', 'Chelist', 'MD', 'Family Practice', 'Urgent Care', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5058968600', '5058968618', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5058968600', '5058968618', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2012-08-27', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1760535074', 0, 'N', 0, '2012-09-07', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000865', 'ABQ000865', 'NM01', 'ABQ Health Partners', 'Aric', '', 'Coffman', 'MD', 'General Surgery', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052627281', '5052627622', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052627281', '5052627622', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Westside Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1942223128', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000465', 'ABQ000465', 'NM01', 'ABQ Health Partners', 'Aric', '', 'Coffman', 'MD', 'General Surgery', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052627281', '5052627622', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052627281', '5052627622', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Westside Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1942223128', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000067', 'ABQ000067', 'NM01', 'ABQ Health Partners', 'Jason', '', 'Cohen', 'MD', 'Hospitalist', '', '', NULL, 'O', '500 Walter St NE Ste 309', 'Albuquerque', 'Bernalillo', 'NM', '87102', '5057278039', '5057278086', '500 Walter St NE Ste 309', 'Albuquerque', 'Bernalillo', 'NM', '87102', '5057278039', '5057278086', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2012-01-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1821179706', 0, 'N', 0, '2012-01-17', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000867', 'ABQ000867', 'NM01', 'ABQ Health Partners', 'Jason', '', 'Cohen', 'MD', 'Hospitalist', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5057278039', '5057278086', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5057278039', '5057278086', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2012-01-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1821179706', 0, 'N', 0, '2012-01-17', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000467', 'ABQ000467', 'NM01', 'ABQ Health Partners', 'Jason', '', 'Cohen', 'MD', 'Hospitalist', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5057278039', '5057278086', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5057278039', '5057278086', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2012-01-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1821179706', 0, 'N', 0, '2012-01-17', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000068', 'ABQ000068', 'NM01', 'ABQ Health Partners', 'Jenette', '', 'Cole', 'CNP', 'Family Practice', '', '', NULL, 'O', '10511 Golf Course Rd NW Ste 103', 'Albuquerque', 'Bernalillo', 'NM', '87114', '5052321100', '5052321153', '10511 Golf Course Rd NW Ste 103', 'Albuquerque', 'Bernalillo', 'NM', '87114', '5052321100', '5052321153', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2012-03-09', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1437459633', 0, 'N', 0, '2012-04-06', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000868', 'ABQ000868', 'NM01', 'ABQ Health Partners', 'Jenette', '', 'Cole', 'CNP', 'Family Practice', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052321100', '5052321153', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052321100', '5052321153', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2012-03-09', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1437459633', 0, 'N', 0, '2012-04-06', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000468', 'ABQ000468', 'NM01', 'ABQ Health Partners', 'Jenette', '', 'Cole', 'CNP', 'Family Practice', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052321100', '5052321153', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052321100', '5052321153', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2012-03-09', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1437459633', 0, 'N', 0, '2012-04-06', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000069', 'ABQ000069', 'NM01', 'ABQ Health Partners', 'Cecilia', '', 'Concepcion', 'MD', 'Pediatrics', '', '', NULL, 'O', '5150 Journal Ctr Blvd NE', 'Albuquerque', 'Bernalillo', 'NM', '87109', '5052623219', '5052623243', '5150 Journal Center Blvd NE', 'Albuquerque', 'Bernalillo', 'NM', '87109', '5052623219', '5052623243', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Womens Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1245230135', 0, 'N', 0, '2011-10-20', NULL, NULL, 35.1702, -106.586, NULL, NULL),
('204043287', 'ABQ000869', 'ABQ000869', 'NM01', 'ABQ Health Partners', 'Cecilia', '', 'Concepcion', 'MD', 'Pediatrics', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052623219', '5052623243', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052623219', '5052623243', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Womens Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1245230135', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000469', 'ABQ000469', 'NM01', 'ABQ Health Partners', 'Cecilia', '', 'Concepcion', 'MD', 'Pediatrics', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052623219', '5052623243', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052623219', '5052623243', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Womens Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1245230135', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000070', 'ABQ000070', 'NM01', 'ABQ Health Partners', 'Richard', '', 'Conn', 'MD', 'Urology', '', '', NULL, 'O', '10511 Golf Course Rd NW Ste 201', 'Albuquerque', 'Bernalillo', 'NM', '87114', '5052321180', '5052321181', '10511 Golf Course Rd NW Ste 201', 'Albuquerque', 'Bernalillo', 'NM', '87114', '5052321180', '5052321181', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Westside Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1205859303', 0, 'N', 0, '2011-10-20', NULL, NULL, 35.2073, -106.676, NULL, NULL),
('204043287', 'ABQ000870', 'ABQ000870', 'NM01', 'ABQ Health Partners', 'Richard', '', 'Conn', 'MD', 'Urology', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052321180', '5052321181', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052321180', '5052321181', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Westside Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1205859303', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000470', 'ABQ000470', 'NM01', 'ABQ Health Partners', 'Richard', '', 'Conn', 'MD', 'Urology', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052321180', '5052321181', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052321180', '5052321181', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Westside Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1205859303', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000871', 'ABQ000871', 'NM01', 'ABQ Health Partners', 'Darcy', '', 'Cooke', 'PA-C', 'General Surgery', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052627281', '5052627622', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052627281', '5052627622', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2013-03-01', 0, 0, 0, 'Lovelace Womens Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1790870970', 0, 'N', 0, '2013-10-03', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000071', 'ABQ000071', 'NM01', 'ABQ Health Partners', 'Darcy', '', 'Cooke', 'PA-C', 'General Surgery', '', '', NULL, 'O', '715 Dr Martin Luther King Jr Ave NE Ste 301', 'Albuquerque', 'Bernalillo', 'NM', '87102', '5052627281', '5052627622', '715 Dr Martin Luther King Jr Ave NE Ste 301', 'Albuquerque', 'Bernalillo', 'NM', '87102', '5052627281', '5052627622', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2013-03-01', 0, 0, 0, 'Lovelace Womens Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1790870970', 0, 'N', 0, '2013-10-03', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000471', 'ABQ000471', 'NM01', 'ABQ Health Partners', 'Darcy', '', 'Cooke', 'PA-C', 'General Surgery', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052627281', '5052627622', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052627281', '5052627622', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2013-03-01', 0, 0, 0, 'Lovelace Womens Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1790870970', 0, 'N', 0, '2013-10-03', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000072', 'ABQ000072', 'NM01', 'ABQ Health Partners', 'Michael', '', 'Coquia', 'MD', 'Internal Medicine', '', '', NULL, 'O', '5150 Journal Ctr Blvd NE', 'Albuquerque', 'Bernalillo', 'NM', '87109', '5052623212', '5052623381', '5150 Journal Center Blvd NE', 'Albuquerque', 'Bernalillo', 'NM', '87109', '5052623212', '5052623381', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1891720082', 0, 'N', 0, '2011-10-20', NULL, NULL, 35.1702, -106.586, NULL, NULL),
('204043287', 'ABQ000872', 'ABQ000872', 'NM01', 'ABQ Health Partners', 'Michael', '', 'Coquia', 'MD', 'Internal Medicine', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052623212', '5052623381', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052623212', '5052623381', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1891720082', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000472', 'ABQ000472', 'NM01', 'ABQ Health Partners', 'Michael', '', 'Coquia', 'MD', 'Internal Medicine', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052623212', '5052623381', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052623212', '5052623381', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1891720082', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000073', 'ABQ000073', 'NM01', 'ABQ Health Partners', 'Curtis', '', 'Cornelius', 'MD', 'Ophthalmology', '', '', NULL, 'O', '5400 Gibson Blvd SE', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052623937', '5052627147', '5400 Gibson Blvd SE', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052623937', '5052627147', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1710900014', 0, 'N', 0, '2011-10-20', NULL, NULL, 35.0583, -106.582, NULL, NULL),
('204043287', 'ABQ000473', 'ABQ000473', 'NM01', 'ABQ Health Partners', 'Curtis', '', 'Cornelius', 'MD', 'Ophthalmology', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052623937', '5052627147', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052623937', '5052627147', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1710900014', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000077', 'ABQ000077', 'NM01', 'ABQ Health Partners', 'Jan', '', 'Cornell', 'MD', 'Urgent Care', '', '', NULL, 'O', '1721 Rio Rancho Blvd SE', 'Rio Rancho', 'Sandoval', 'NM', '87124', '5058968604', '5058968697', '1721 Rio Rancho Blvd SE', 'Rio Rancho', 'Sandoval', 'NM', '87124', '5058968604', '5058968697', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2012-01-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1306908132', 0, 'Y', 0, '2012-01-17', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000874', 'ABQ000874', 'NM01', 'ABQ Health Partners', 'Jan', '', 'Cornell', 'MD', 'Urgent Care', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5058968604', '5058968697', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5058968604', '5058968697', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2012-01-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1306908132', 0, 'Y', 0, '2012-01-17', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000474', 'ABQ000474', 'NM01', 'ABQ Health Partners', 'Jan', '', 'Cornell', 'MD', 'Urgent Care', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5058968604', '5058968697', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5058968604', '5058968697', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2012-01-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1306908132', 0, 'N', 0, '2012-01-17', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000078', 'ABQ000078', 'NM01', 'ABQ Health Partners', 'Holly', '', 'Couture', 'DO', 'Family Practice', '', '', NULL, 'O', '2929 Coors Blvd NW Ste 200', 'Albuquerque', 'Bernalillo', 'NM', '87120', '5058392300', '5058392303', '2929 Coors Blvd NW Ste 200', 'Albuquerque', 'Bernalillo', 'NM', '87120', '5058392300', '5058392303', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Westside Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1639353402', 0, 'N', 0, '2011-10-20', NULL, NULL, 35.1168, -106.702, NULL, NULL),
('204043287', 'ABQ000878', 'ABQ000878', 'NM01', 'ABQ Health Partners', 'Holly', '', 'Couture', 'DO', 'Family Practice', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5058392300', '5058392303', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5058392300', '5058392303', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Westside Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1639353402', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000478', 'ABQ000478', 'NM01', 'ABQ Health Partners', 'Holly', '', 'Couture', 'DO', 'Family Practice', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5058392300', '5058392303', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5058392300', '5058392303', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Westside Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1639353402', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000079', 'ABQ000079', 'NM01', 'ABQ Health Partners', 'Mark', '', 'Crawford', 'MD', 'Orthopedic Surgery', '', '', NULL, 'O', '5310 Homestead Rd NE Ste 201', 'Albuquerque', 'Bernalillo', 'NM', '87110', '5052620050', '5052620019', '5310 Homestead Rd NE Ste 201', 'Albuquerque', 'Bernalillo', 'NM', '87110', '5052620050', '5052620019', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Westside Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1619970654', 0, 'N', 0, '2011-10-20', NULL, NULL, 35.1289, -106.584, NULL, NULL),
('204043287', 'ABQ000879', 'ABQ000879', 'NM01', 'ABQ Health Partners', 'Mark', '', 'Crawford', 'MD', 'Orthopedic Surgery', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052620050', '5052620019', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052620050', '5052620019', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Westside Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1619970654', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000479', 'ABQ000479', 'NM01', 'ABQ Health Partners', 'Mark', '', 'Crawford', 'MD', 'Orthopedic Surgery', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052620050', '5052620019', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052620050', '5052620019', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Westside Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1619970654', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000080', 'ABQ000080', 'NM01', 'ABQ Health Partners', 'Robert', '', 'Culling', 'DO', 'Pain Management', '', '', NULL, 'O', '10511 Golf Course Rd NW Ste 203', 'Albuquerque', 'Bernalillo', 'NM', '87114', '5052321150', '5052321151', '10511 Golf Course Rd NW Ste 203', 'Albuquerque', 'Bernalillo', 'NM', '87114', '5052321150', '5052321151', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2012-10-19', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1245253350', 0, 'N', 0, '2012-11-12', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000880', 'ABQ000880', 'NM01', 'ABQ Health Partners', 'Robert', '', 'Culling', 'DO', 'Pain Management', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052321150', '5052321151', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052321150', '5052321151', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2012-10-19', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1245253350', 0, 'N', 0, '2012-11-12', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000480', 'ABQ000480', 'NM01', 'ABQ Health Partners', 'Robert', '', 'Culling', 'DO', 'Pain Management', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052321150', '5052321151', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052321150', '5052321151', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2012-10-19', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1245253350', 0, 'N', 0, '2012-11-12', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000359', 'ABQ000359', 'NM01', 'ABQ Health Partners', 'Gina', '', 'Waymire', 'MD', 'Pediatrics', '', '', NULL, 'O', '5400 Gibson Blvd SE', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052627594', '5052627641', '5400 Gibson Blvd SE', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052627594', '5052627641', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1275556375', 0, 'N', 0, '2011-10-20', NULL, NULL, 35.0583, -106.582, NULL, NULL),
('204043287', 'ABQ000759', 'ABQ000759', 'NM01', 'ABQ Health Partners', 'Gina', '', 'Waymire', 'MD', 'Pediatrics', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052627594', '5052627641', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052627594', '5052627641', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1275556375', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000081', 'ABQ000081', 'NM01', 'ABQ Health Partners', 'Marjorie', '', 'Cypress', 'NP', 'Endocrinology', '', '', NULL, 'O', '5400 Gibson Blvd SE', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052627455', '5052623955', '5400 Gibson Blvd SE', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052627455', '5052623955', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1013104504', 0, 'N', 0, '2011-10-20', NULL, NULL, 35.0583, -106.582, NULL, NULL),
('204043287', 'ABQ000481', 'ABQ000481', 'NM01', 'ABQ Health Partners', 'Marjorie', '', 'Cypress', 'NP', 'Endocrinology', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052627455', '5052623955', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052627455', '5052623955', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1013104504', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000358', 'ABQ000358', 'NM01', 'ABQ Health Partners', 'Paul', '', 'Warfield', 'MD', 'Gastroenterology', '', '', NULL, 'O', '5400 Gibson Blvd SE', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052627174', '5052623562', '5400 Gibson Blvd SE', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052627174', '5052623562', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Medical Center', 'Lovelace Westside Hospital', NULL, NULL, 'HCFA|UB|', '1841206422', 0, 'N', 0, '2013-09-24', NULL, NULL, 35.0583, -106.582, NULL, NULL);
INSERT INTO `providers_new` (`Provider_Tax_ID`, `Provider_Suffix`, `Provider_Network_ID`, `Provider_Region`, `Provider_Name`, `Provider_Doctor_First_Name`, `Provider_Doctor_Middle_Name`, `Provider_Doctor_Last_Name`, `Provider_Doctor_Degree`, `Provider_Specialty_1`, `Provider_Specialty_2`, `Provider_Specialty_3`, `Provider_Specialty_4`, `Provider_Address_Type`, `Provider_Address`, `Provider_City`, `Provider_County`, `Provider_State`, `Provider_Zip`, `Provider_Phone`, `Provider_Fax`, `Provider_Mailing_Address`, `Provider_Mailing_City`, `Provider_Mailing_County`, `Provider_Mailing_State`, `Provider_Mailing_Zip`, `Provider_Mailing_Phone`, `Provider_Mailing_Fax`, `Provider_Primary_Schedule`, `Provider_Secondary_Schedule`, `Provider_Rate_Sheet`, `Provider_Anes_Rate`, `Provider_Default_Rate`, `Provider_Max_DOS`, `Provider_Min_Match_Value`, `Provider_Effective_Date`, `Provider_Term_Date`, `Provider_Pend`, `Provider_Anes_Minutes`, `Provider_PPO`, `Provider_Hospital_1`, `Provider_Hospital_2`, `Provider_Hospital_3`, `Provider_Hospital_4`, `Provider_Type`, `Provider_NPI`, `Provider_Check_Override`, `Exclude_Dir`, `Audit_Status`, `Last_Change_Date`, `Medicare_ID`, `Provider_Lang`, `Provider_Latitude`, `Provider_Longitude`, `Provider_school`, `Provider_cert`) VALUES
('204043287', 'ABQ000758', 'ABQ000758', 'NM01', 'ABQ Health Partners', 'Paul', '', 'Warfield', 'MD', 'Gastroenterology', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052627600', '0000000000', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052627600', '0000000000', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Medical Center', 'Lovelace Westside Hospital', NULL, NULL, 'HCFA|UB|', '1841206422', 0, 'N', 0, '2013-09-24', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000082', 'ABQ000082', 'NM01', 'ABQ Health Partners', 'Susan', '', 'Daniels', 'CNM', 'Obstetrics and Gynecology', '', '', NULL, 'O', '5150 Journal Ctr Blvd NE', 'Albuquerque', 'Bernalillo', 'NM', '87109', '5052546500', '5052623198', '5150 Journal Ctr Blvd NE', 'Albuquerque', 'Bernalillo', 'NM', '87109', '5052546500', '5052623198', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Womens Hospital', 'Lovelace Westside Hospital', '', '', 'HCFA|UB|', '1245265222', 0, 'N', 0, '2014-06-24', NULL, NULL, 35.1702, -106.586, NULL, NULL),
('204043287', 'ABQ000882', 'ABQ000882', 'NM01', 'ABQ Health Partners', 'Susan', '', 'Daniels', 'CNM', 'Obstetrics and Gynecology', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052546500', '5052623198', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052546500', '5052623198', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Womens Hospital', 'Lovelace Westside Hospital', '', '', 'HCFA|UB|', '1245265222', 0, 'N', 0, '2014-06-24', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000482', 'ABQ000482', 'NM01', 'ABQ Health Partners', 'Susan', '', 'Daniels', 'CNM', 'Obstetrics and Gynecology', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052546500', '5052623198', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052546500', '5052623198', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Womens Hospital', 'Lovelace Westside Hospital', '', '', 'HCFA|UB|', '1245265222', 0, 'N', 0, '2014-06-24', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000357', 'ABQ000357', 'NM01', 'ABQ Health Partners', 'Leslie', '', 'Ward', 'MD', 'Pediatrics', '', '', NULL, 'O', '5150 Journal Ctr Blvd NE', 'Albuquerque', 'Bernalillo', 'NM', '87109', '5052623219', '5052623243', '5150 Journal Center Blvd NE', 'Albuquerque', 'Bernalillo', 'NM', '87109', '5052623219', '5052623243', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Womens Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1063447258', 0, 'N', 0, '2011-10-20', NULL, NULL, 35.1702, -106.586, NULL, NULL),
('204043287', 'ABQ001157', 'ABQ001157', 'NM01', 'ABQ Health Partners', 'Leslie', '', 'Ward', 'MD', 'Pediatrics', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052623219', '5052623243', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052623219', '5052623243', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Womens Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1063447258', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000757', 'ABQ000757', 'NM01', 'ABQ Health Partners', 'Leslie', '', 'Ward', 'MD', 'Pediatrics', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052623219', '5052623243', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052623219', '5052623243', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Womens Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1063447258', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000356', 'ABQ000356', 'NM01', 'ABQ Health Partners', 'Dale', '', 'Walaszek', 'PA-C', 'Urgent Care', '', '', NULL, 'O', '200 Rio Bravo Blvd SE', 'Albuquerque', 'Bernalillo', 'NM', '87105', '5058736401', '5058736408', '200 Rio Bravo Blvd SE', 'Albuquerque', 'Bernalillo', 'NM', '87105', '5058736401', '5058736408', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2012-01-01', 0, 0, 0, 'Lovelace Womens Hospital', '', '', '', 'HCFA|UB|', '1962512293', 0, 'Y', 0, '2014-04-29', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ001153', 'ABQ001153', 'NM01', 'ABQ Health Partners', 'Dale', '', 'Walaszek', 'PA-C', 'Urgent Care', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5058968604', '5058968697', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5058968604', '5058968697', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2014-04-01', 0, 0, 0, 'Lovelace Womens Hospital', '', '', '', 'HCFA|UB|', '1962512293', 0, 'N', 0, '2014-04-29', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000753', 'ABQ000753', 'NM01', 'ABQ Health Partners', 'Dale', '', 'Walaszek', 'PA-C', 'Urgent Care', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5058968604', '5058968697', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5058968604', '5058968697', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2014-04-01', 0, 0, 0, 'Lovelace Womens Hospital', '', '', '', 'HCFA|UB|', '1962512293', 0, 'N', 0, '2014-04-29', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000084', 'ABQ000084', 'NM01', 'ABQ Health Partners', 'Lyn', '', 'Dawson', 'NP', 'Pain Management', '', '', NULL, 'O', '10511 Golf Course Rd NW Ste 203', 'Albuquerque', 'Bernalillo', 'NM', '87110', '5052321150', '5052321151', '10511 Golf Course Rd NW Ste 203', 'Albuquerque', 'Bernalillo', 'NM', '87110', '5052321150', '5052321151', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1568643146', 0, 'N', 0, '2012-05-25', NULL, NULL, 35.2073, -106.676, NULL, NULL),
('204043287', 'ABQ000883', 'ABQ000883', 'NM01', 'ABQ Health Partners', 'Lyn', '', 'Dawson', 'NP', 'Pain Management', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052321150', '5052321151', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052321150', '5052321151', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1568643146', 0, 'N', 0, '2012-05-25', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000483', 'ABQ000483', 'NM01', 'ABQ Health Partners', 'Lyn', '', 'Dawson', 'NP', 'Pain Management', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052321150', '5052321151', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052321150', '5052321151', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1568643146', 0, 'N', 0, '2012-05-25', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000085', 'ABQ000085', 'NM01', 'ABQ Health Partners', 'Patrick', '', 'Dawson', 'MD', 'Obstetrics and Gynecology', '', '', NULL, 'O', '4705 Montgomery Blvd NE Ste 301-302', 'Albuquerque', 'Bernalillo', 'NM', '87109', '5052546500', '5052546532', '4705 Montgomery Blvd NE Ste 301-302', 'Albuquerque', 'Bernalillo', 'NM', '87109', '5052546500', '5052546532', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2012-09-01', 0, 0, 0, 'Lovelace Medical Center', '', '', '', 'HCFA|UB|', '1356598726', 0, 'N', 0, '2013-10-30', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000885', 'ABQ000885', 'NM01', 'ABQ Health Partners', 'Patrick', '', 'Dawson', 'MD', 'Obstetrics and Gynecology', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052546500', '5052546532', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052546500', '5052546532', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2012-09-01', 0, 0, 0, 'Lovelace Medical Center', '', '', '', 'HCFA|UB|', '1356598726', 0, 'N', 0, '2013-10-30', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000485', 'ABQ000485', 'NM01', 'ABQ Health Partners', 'Patrick', '', 'Dawson', 'MD', 'Obstetrics and Gynecology', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052546500', '5052546532', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052546500', '5052546532', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2012-09-01', 0, 0, 0, 'Lovelace Medical Center', '', '', '', 'HCFA|UB|', '1356598726', 0, 'N', 0, '2013-10-30', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000886', 'ABQ000886', 'NM01', 'ABQ Health Partners', 'Adair', '', 'De Berry-Carlisle', 'DO', 'General Surgery', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052627281', '5052627622', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052627281', '5052627622', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2012-04-30', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1730110651', 0, 'N', 0, '2012-05-25', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000086', 'ABQ000086', 'NM01', 'ABQ Health Partners', 'Adair', '', 'De Berry-Carlisle', 'DO', 'General Surgery', '', '', NULL, 'O', '715 Dr Martin Luther King Jr Ave NE Ste 301', 'Albuquerque', 'Bernalillo', 'NM', '87102', '5052627281', '5052627622', '715 Dr Martin Luther King Jr Ave NE Ste 301', 'Albuquerque', 'Bernalillo', 'NM', '87102', '5052627281', '5052627622', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2012-04-30', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1730110651', 0, 'N', 0, '2012-05-25', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000486', 'ABQ000486', 'NM01', 'ABQ Health Partners', 'Adair', '', 'De Berry-Carlisle', 'DO', 'General Surgery', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052627281', '5052627622', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052627281', '5052627622', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2012-04-30', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1730110651', 0, 'N', 0, '2012-05-25', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000087', 'ABQ000087', 'NM01', 'ABQ Health Partners', 'Sushma', '', 'Dharia', 'MD', 'Pulmonary', '', '', NULL, 'O', '500 Walter St NE Ste 205', 'Albuquerque', 'Bernalillo', 'NM', '87102', '5052627223', '5052627450', '500 Walter St NE Ste 205', 'Albuquerque', 'Bernalillo', 'NM', '87102', '5052627223', '5052627450', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2012-01-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1497734719', 0, 'N', 0, '2012-01-17', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000887', 'ABQ000887', 'NM01', 'ABQ Health Partners', 'Sushma', '', 'Dharia', 'MD', 'Pulmonary', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052627223', '5052627450', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052627223', '5052627450', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2012-01-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1497734719', 0, 'N', 0, '2012-01-17', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000487', 'ABQ000487', 'NM01', 'ABQ Health Partners', 'Sushma', '', 'Dharia', 'MD', 'Pulmonary', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052627223', '5052627450', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052627223', '5052627450', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2012-01-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1497734719', 0, 'N', 0, '2012-01-17', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000088', 'ABQ000088', 'NM01', 'ABQ Health Partners', 'John', '', 'Doggett', 'MD', 'Sleep Medicine', '', '', NULL, 'O', '4700 Jefferson St NE Ste 800', 'Albuquerque', 'Bernalillo', 'NM', '87109', '5058726000', '5058726003', '4700 Jefferson St NE Ste 800', 'Albuquerque', 'Bernalillo', 'NM', '87109', '5058726000', '5058726003', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1336162437', 0, 'N', 0, '2011-10-20', NULL, NULL, 35.1342, -106.593, NULL, NULL),
('204043287', 'ABQ000888', 'ABQ000888', 'NM01', 'ABQ Health Partners', 'John', '', 'Doggett', 'MD', 'Sleep Medicine', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5058726000', '5058726003', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5058726000', '5058726003', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1336162437', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000488', 'ABQ000488', 'NM01', 'ABQ Health Partners', 'John', '', 'Doggett', 'MD', 'Sleep Medicine', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5058726000', '5058726003', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5058726000', '5058726003', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1336162437', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000352', 'ABQ000352', 'NM01', 'ABQ Health Partners', 'Carmen', '', 'Wagner-Mogle', 'MD', 'Family Practice', '', '', NULL, 'O', '2929 Coors Blvd NW Ste 200', 'Albuquerque', 'Bernalillo', 'NM', '87120', '5058392300', '5058392303', '2929 Coors Blvd NW Ste 200', 'Albuquerque', 'Bernalillo', 'NM', '87120', '5058392300', '5058392303', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2012-01-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1831122332', 0, 'N', 0, '2012-01-17', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ001152', 'ABQ001152', 'NM01', 'ABQ Health Partners', 'Carmen', '', 'Wagner-Mogle', 'MD', 'Family Practice', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5058392300', '5058392303', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5058392300', '5058392303', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2012-01-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1831122332', 0, 'N', 0, '2012-01-17', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000752', 'ABQ000752', 'NM01', 'ABQ Health Partners', 'Carmen', '', 'Wagner-Mogle', 'MD', 'Family Practice', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5058392300', '5058392303', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5058392300', '5058392303', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2012-01-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1831122332', 0, 'N', 0, '2012-01-17', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000090', 'ABQ000090', 'NM01', 'ABQ Health Partners', 'Charlie', '', 'Doss', 'MD', 'General Surgery', '', '', NULL, 'O', '10511 Golf Course Road NW Ste 202', 'Albuquerque', 'Bernalillo', 'NM', '87114', '5052321160', '5052321161', '10511 Golf Course Road NW Suite 202', 'Albuquerque', 'Bernalillo', 'NM', '87114', '5052321160', '5052321161', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Westside Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1356480370', 0, 'N', 0, '2011-10-20', NULL, NULL, 35.2073, -106.676, NULL, NULL),
('204043287', 'ABQ000889', 'ABQ000889', 'NM01', 'ABQ Health Partners', 'Charlie', '', 'Doss', 'MD', 'General Surgery', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052321160', '5052321161', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052321160', '5052321161', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Westside Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1356480370', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000489', 'ABQ000489', 'NM01', 'ABQ Health Partners', 'Charlie', '', 'Doss', 'MD', 'General Surgery', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052321160', '5052321161', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052321160', '5052321161', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Westside Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1356480370', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000091', 'ABQ000091', 'NM01', 'ABQ Health Partners', 'Heather', '', 'Dountas', 'PA-C', 'Family Practice', '', '', NULL, 'O', '3901 Carlisle Blvd NE', 'Albuquerque', 'Bernalillo', 'NM', '87107', '5058888500', '5058888503', '3901 Carlisle Blvd NE', 'Albuquerque', 'Bernalillo', 'NM', '87107', '5058888500', '5058888503', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1407889074', 0, 'N', 0, '2011-10-20', NULL, NULL, 35.1252, -106.604, NULL, NULL),
('204043287', 'ABQ000891', 'ABQ000891', 'NM01', 'ABQ Health Partners', 'Heather', '', 'Dountas', 'PA-C', 'Family Practice', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5058888500', '5058888503', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5058888500', '5058888503', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1407889074', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000491', 'ABQ000491', 'NM01', 'ABQ Health Partners', 'Heather', '', 'Dountas', 'PA-C', 'Family Practice', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5058888500', '5058888503', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5058888500', '5058888503', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1407889074', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000092', 'ABQ000092', 'NM01', 'ABQ Health Partners', 'James', '', 'Drennan', 'MD', 'Orthopedic Surgery', '', '', NULL, 'O', '5150 Journal Ctr Blvd NE', 'Albuquerque', 'Bernalillo', 'NM', '87109', '5053428400', '5053428401', '5150 Journal Ctr Blvd NE', 'Albuquerque', 'Bernalillo', 'NM', '87109', '5053428400', '5053428401', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2013-07-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1992728091', 0, 'N', 0, '2013-08-15', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000892', 'ABQ000892', 'NM01', 'ABQ Health Partners', 'James', '', 'Drennan', 'MD', 'Orthopedic Surgery', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5053428400', '5053428401', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5053428400', '5053428401', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2013-07-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1992728091', 0, 'N', 0, '2013-08-15', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000492', 'ABQ000492', 'NM01', 'ABQ Health Partners', 'James', '', 'Drennan', 'MD', 'Orthopedic Surgery', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5053428400', '5053428401', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5053428400', '5053428401', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2013-07-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1992728091', 0, 'N', 0, '2013-08-15', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000093', 'ABQ000093', 'NM01', 'ABQ Health Partners', 'Susan', '', 'Duke', 'DO', 'Hospitalist', '', '', NULL, 'O', '500 Walter St NE Ste 309', 'Albuquerque', 'Bernalillo', 'NM', '87102', '5057278039', '5057278086', '500 Walter St NE Ste 309', 'Albuquerque', 'Bernalillo', 'NM', '87102', '5057278039', '5057278086', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2013-05-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1477577708', 0, 'N', 0, '2013-05-30', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000893', 'ABQ000893', 'NM01', 'ABQ Health Partners', 'Susan', '', 'Duke', 'DO', 'Hospitalist', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5057278039', '5057278086', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5057278039', '5057278086', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2013-05-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1477577708', 0, 'N', 0, '2013-05-30', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000493', 'ABQ000493', 'NM01', 'ABQ Health Partners', 'Susan', '', 'Duke', 'DO', 'Hospitalist', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5057278039', '5057278086', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5057278039', '5057278086', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2013-05-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1477577708', 0, 'N', 0, '2013-05-30', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000097', 'ABQ000097', 'NM01', 'ABQ Health Partners', 'Stephen', '', 'Dunlap', 'MD', 'Urgent Care', '', '', NULL, 'O', '1721 Rio Rancho Blvd SE', 'Rio Rancho', 'Sandoval', 'NM', '87124', '5058968604', '5058968697', '1721 Rio Rancho Blvd SE', 'Rio Rancho', 'Sandoval', 'NM', '87124', '5058968604', '5058968697', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Womens Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1700811809', 0, 'Y', 0, '2012-01-17', NULL, NULL, 35.2284, -106.66, NULL, NULL),
('204043287', 'ABQ000894', 'ABQ000894', 'NM01', 'ABQ Health Partners', 'Stephen', '', 'Dunlap', 'MD', 'Urgent Care', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5058968604', '5058968697', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5058968604', '5058968697', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Womens Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1700811809', 0, 'Y', 0, '2012-01-17', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000494', 'ABQ000494', 'NM01', 'ABQ Health Partners', 'Stephen', '', 'Dunlap', 'MD', 'Urgent Care', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5058968604', '5058968697', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5058968604', '5058968697', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Womens Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1700811809', 0, 'N', 0, '2012-01-17', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000351', 'ABQ000351', 'NM01', 'ABQ Health Partners', 'George', '', 'Vasilion', 'DO', 'Family Practice', '', '', NULL, 'O', '1901 Juan Tabo Blvd NE', 'Albuquerque', 'Bernalillo', 'NM', '87112', '5052629200', '5052629201', '1901 Juan Tabo Blvd NE', 'Albuquerque', 'Bernalillo', 'NM', '87112', '5052629200', '5052629201', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Medical Center', 'Lovelace Womens Hospital', 'Lovelace Westside Hospital ', NULL, 'HCFA|UB|', '1578598405', 0, 'N', 0, '2011-10-20', NULL, NULL, 35.1032, -106.516, NULL, NULL),
('204043287', 'ABQ001151', 'ABQ001151', 'NM01', 'ABQ Health Partners', 'George', '', 'Vasilion', 'DO', 'Family Practice', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052629200', '5052629201', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052629200', '5052629201', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Medical Center', 'Lovelace Womens Hospital', 'Lovelace Westside Hospital ', NULL, 'HCFA|UB|', '1578598405', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000751', 'ABQ000751', 'NM01', 'ABQ Health Partners', 'George', '', 'Vasilion', 'DO', 'Family Practice', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052629200', '5052629201', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052629200', '5052629201', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Medical Center', 'Lovelace Womens Hospital', 'Lovelace Westside Hospital ', NULL, 'HCFA|UB|', '1578598405', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000101', 'ABQ000101', 'NM01', 'ABQ Health Partners', 'Lori', '', 'Eanes', 'DO', 'Urgent Care', '', '', NULL, 'O', '5150 Journal Ctr Blvd NE', 'Albuquerque', 'Bernalillo', 'NM', '87109', '5052623233', '5052623191', '5150 Journal Center Blvd NE', 'Albuquerque', 'Bernalillo', 'NM', '87109', '5052623233', '5052623191', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1528091196', 0, 'Y', 0, '2012-01-17', NULL, NULL, 35.1702, -106.586, NULL, NULL),
('204043287', 'ABQ000350', 'ABQ000350', 'NM01', 'ABQ Health Partners', 'Dirk', '', 'Vandergon', 'MD', 'Cardiology', '', '', NULL, 'O', '500 Walter St NE Ste 401', 'Albuquerque', 'Bernalillo', 'NM', '87102', '5052627451', '5052627870', '500 Walter St NE Ste 401', 'Albuquerque', 'Bernalillo', 'NM', '87102', '5052627451', '5052627870', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Medical Center', 'Lovelace Womens Hospital', 'Lovelace Westside Hospital ', NULL, 'HCFA|UB|', '1659334316', 0, 'N', 0, '2012-07-06', NULL, NULL, 35.0863, -106.64, NULL, NULL),
('204043287', 'ABQ001150', 'ABQ001150', 'NM01', 'ABQ Health Partners', 'Dirk', '', 'Vandergon', 'MD', 'Cardiology', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052627451', '5052627870', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052627451', '5052627870', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Medical Center', 'Lovelace Womens Hospital', 'Lovelace Westside Hospital ', NULL, 'HCFA|UB|', '1659334316', 0, 'N', 0, '2012-07-06', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000750', 'ABQ000750', 'NM01', 'ABQ Health Partners', 'Dirk', '', 'Vandergon', 'MD', 'Cardiology', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052627451', '5052627870', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052627451', '5052627870', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Medical Center', 'Lovelace Womens Hospital', 'Lovelace Westside Hospital ', NULL, 'HCFA|UB|', '1659334316', 0, 'N', 0, '2012-07-06', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000898', 'ABQ000898', 'NM01', 'ABQ Health Partners', 'Lori', '', 'Eanes', 'DO', 'Urgent Care', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5058968604', '5058968697', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5058968604', '5058968697', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1528091196', 0, 'Y', 0, '2012-01-17', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000498', 'ABQ000498', 'NM01', 'ABQ Health Partners', 'Lori', '', 'Eanes', 'DO', 'Urgent Care', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5058968604', '5058968697', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5058968604', '5058968697', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1528091196', 0, 'N', 0, '2012-01-17', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000349', 'ABQ000349', 'NM01', 'ABQ Health Partners', 'Patricia', '', 'Van Sciver', 'NP', 'Pulmonary', '', '', NULL, 'O', '500 Walter St NE Ste 205', 'Albuquerque', 'Bernalillo', 'NM', '87102', '5052627223', '5052627450', '500 Walter St NE Ste 205', 'Albuquerque', 'Bernalillo', 'NM', '87102', '5052627223', '5052627450', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Medical Center', 'Lovelace Westside Hospital', NULL, NULL, 'HCFA|UB|', '1073536959', 0, 'N', 0, '2011-10-20', NULL, NULL, 35.0863, -106.64, NULL, NULL),
('204043287', 'ABQ001149', 'ABQ001149', 'NM01', 'ABQ Health Partners', 'Patricia', '', 'Van Sciver', 'NP', 'Pulmonary', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052627223', '5052627450', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052627223', '5052627450', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Medical Center', 'Lovelace Westside Hospital', NULL, NULL, 'HCFA|UB|', '1073536959', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000749', 'ABQ000749', 'NM01', 'ABQ Health Partners', 'Patricia', '', 'Van Sciver', 'NP', 'Pulmonary', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052627223', '5052627450', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052627223', '5052627450', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Medical Center', 'Lovelace Westside Hospital', NULL, NULL, 'HCFA|UB|', '1073536959', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000105', 'ABQ000105', 'NM01', 'ABQ Health Partners', 'Megan', '', 'Edwards', 'MD', 'Urgent Care', '', '', NULL, 'O', '9101 Montgomery Blvd NE', 'Albuquerque', 'Bernalillo', 'NM', '87111', '5052754259', '5052754223', '9101 Montgomery Blvd NE', 'Albuquerque', 'Bernalillo', 'NM', '87111', '5052754259', '5052754223', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2012-01-23', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1821011933', 0, 'Y', 0, '2012-02-16', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000902', 'ABQ000902', 'NM01', 'ABQ Health Partners', 'Megan', '', 'Edwards', 'MD', 'Urgent Care', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5058968604', '5058968697', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5058968604', '5058968697', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2012-01-23', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1821011933', 0, 'Y', 0, '2012-02-16', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000502', 'ABQ000502', 'NM01', 'ABQ Health Partners', 'Megan', '', 'Edwards', 'MD', 'Urgent Care', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5058968604', '5058968697', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5058968604', '5058968697', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2012-01-23', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1821011933', 0, 'N', 0, '2012-02-16', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000106', 'ABQ000106', 'NM01', 'ABQ Health Partners', 'Patricia', '', 'Engleman', 'CNP', 'Pediatrics', '', '', NULL, 'O', '5400 Gibson Blvd SE', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052627594', '5052627641', '5400 Gibson Blvd SE', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052627594', '5052627641', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1528159100', 0, 'N', 0, '2011-10-20', NULL, NULL, 35.0583, -106.582, NULL, NULL),
('204043287', 'ABQ000506', 'ABQ000506', 'NM01', 'ABQ Health Partners', 'Patricia', '', 'Engleman', 'CNP', 'Pediatrics', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052627594', '5052627641', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052627594', '5052627641', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1528159100', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000107', 'ABQ000107', 'NM01', 'ABQ Health Partners', 'Abdolhossein', '', 'Entezari', 'PhD', 'Psychology', '', '', NULL, 'O', '5150 Journal Ctr Blvd NE', 'Albuquerque', 'Bernalillo', 'NM', '87109', '5052623212', '5052623381', '5150 Journal Center Blvd NE', 'Albuquerque', 'Bernalillo', 'NM', '87109', '5052623212', '5052623381', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1891876769', 0, 'N', 0, '2011-10-20', NULL, NULL, 35.1702, -106.586, NULL, NULL),
('204043287', 'ABQ000907', 'ABQ000907', 'NM01', 'ABQ Health Partners', 'Abdolhossein', '', 'Entezari', 'PhD', 'Psychology', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052623212', '5052623381', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052623212', '5052623381', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1891876769', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000507', 'ABQ000507', 'NM01', 'ABQ Health Partners', 'Abdolhossein', '', 'Entezari', 'PhD', 'Psychology', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052623212', '5052623381', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052623212', '5052623381', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1891876769', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000108', 'ABQ000108', 'NM01', 'ABQ Health Partners', 'James', '', 'Etre', 'OD', 'Optometry', '', '', NULL, 'O', '5150 Journal Ctr Blvd NE', 'Albuquerque', 'Bernalillo', 'NM', '87109', '5052623937', '5052623366', '5150 Journal Center Blvd NE', 'Albuquerque', 'Bernalillo', 'NM', '87109', '5052623937', '5052623366', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1053346155', 0, 'N', 0, '2011-10-20', NULL, NULL, 35.1702, -106.586, NULL, NULL),
('204043287', 'ABQ000908', 'ABQ000908', 'NM01', 'ABQ Health Partners', 'James', '', 'Etre', 'OD', 'Optometry', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052623937', '5052623366', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052623937', '5052623366', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1053346155', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000508', 'ABQ000508', 'NM01', 'ABQ Health Partners', 'James', '', 'Etre', 'OD', 'Optometry', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052623937', '5052623366', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052623937', '5052623366', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1053346155', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000909', 'ABQ000909', 'NM01', 'ABQ Health Partners', 'Melanie', '', 'Falgout', 'MD', 'Family Practice', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052754288', '5052754203', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052754288', '5052754203', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1649442476', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000109', 'ABQ000109', 'NM01', 'ABQ Health Partners', 'Melanie', '', 'Falgout', 'MD', 'Family Practice', '', '', NULL, 'O', '9101 Montgomery Blvd NE', 'Albuquerque', 'Bernalillo', 'NM', '87111', '5052754288', '5052754203', '9101 Montgomery Blvd NE', 'Albuquerque', 'Bernalillo', 'NM', '87111', '5052754288', '5052754203', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1649442476', 0, 'N', 0, '2011-10-20', NULL, NULL, 35.1307, -106.542, NULL, NULL),
('204043287', 'ABQ000509', 'ABQ000509', 'NM01', 'ABQ Health Partners', 'Melanie', '', 'Falgout', 'MD', 'Family Practice', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052754288', '5052754203', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052754288', '5052754203', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1649442476', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000110', 'ABQ000110', 'NM01', 'ABQ Health Partners', 'Beverly', '', 'Firth', 'CNS', 'Nurse Practitioner', '', '', NULL, 'O', '500 Walter St NE Ste 301', 'Albuquerque', 'Bernalillo', 'NM', '87102', '5052623851', '5052627040', '500 Walter St NE Ste 301', 'Albuquerque', 'Bernalillo', 'NM', '87102', '5052623851', '5052627040', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1740431311', 0, 'N', 0, '2013-09-04', NULL, NULL, 35.0863, -106.64, NULL, NULL),
('204043287', 'ABQ000910', 'ABQ000910', 'NM01', 'ABQ Health Partners', 'Beverly', '', 'Firth', 'CNS', 'Nurse Practitioner', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052623851', '5052627040', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052623851', '5052627040', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1740431311', 0, 'N', 0, '2013-09-04', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000510', 'ABQ000510', 'NM01', 'ABQ Health Partners', 'Beverly', '', 'Firth', 'CNS', 'Nurse Practitioner', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052623851', '5052627040', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052623851', '5052627040', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1740431311', 0, 'N', 0, '2013-09-04', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000348', 'ABQ000348', 'NM01', 'ABQ Health Partners', 'Robert', '', 'Valenzuela', 'MD', 'Hospitalist', '', '', NULL, 'O', '500 Walter St NE Ste 401', 'Albuquerque', 'Bernalillo', 'NM', '87102', '5057278039', '5057278086', '500 Walter St NE Ste 401', 'Albuquerque', 'Bernalillo', 'NM', '87102', '5057278039', '5057278086', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Medical Center', 'Lovelace Westside Hospital', NULL, NULL, 'HCFA|UB|', '1699776492', 0, 'N', 0, '2014-06-13', NULL, NULL, 35.0863, -106.64, NULL, NULL),
('204043287', 'ABQ001148', 'ABQ001148', 'NM01', 'ABQ Health Partners', 'Robert', '', 'Valenzuela', 'MD', 'Hospitalist', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5057278039', '5057278086', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5057278039', '5057278086', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Medical Center', 'Lovelace Westside Hospital', NULL, NULL, 'HCFA|UB|', '1699776492', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000748', 'ABQ000748', 'NM01', 'ABQ Health Partners', 'Robert', '', 'Valenzuela', 'MD', 'Hospitalist', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5057278039', '5057278086', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5057278039', '5057278086', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Medical Center', 'Lovelace Westside Hospital', NULL, NULL, 'HCFA|UB|', '1699776492', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000111', 'ABQ000111', 'NM01', 'ABQ Health Partners', 'Patricia', '', 'Fitch', 'OD', 'Optometry', '', '', NULL, 'O', '5400 Gibson Blvd SE', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052623937', '5052627147', '5400 Gibson Blvd SE', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052623937', '5052627147', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1811922891', 0, 'N', 0, '2011-10-20', NULL, NULL, 35.0583, -106.582, NULL, NULL),
('204043287', 'ABQ000511', 'ABQ000511', 'NM01', 'ABQ Health Partners', 'Patricia', '', 'Fitch', 'OD', 'Optometry', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052623937', '5052627147', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052623937', '5052627147', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1811922891', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000112', 'ABQ000112', 'NM01', 'ABQ Health Partners', 'Matthew', '', 'Fitch', 'PA-C', 'Family Practice', '', '', NULL, 'O', '1901 Juan Tabo Blvd NE', 'Albuquerque', 'Bernalillo', 'NM', '87112', '5052629200', '5052629201', '1901 Juan Tabo Blvd NE', 'Albuquerque', 'Bernalillo', 'NM', '87112', '5052629200', '5052629201', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1417281171', 0, 'N', 0, '2012-05-25', NULL, NULL, 35.1032, -106.516, NULL, NULL),
('204043287', 'ABQ000912', 'ABQ000912', 'NM01', 'ABQ Health Partners', 'Matthew', '', 'Fitch', 'PA-C', 'Family Practice', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052629200', '5052629201', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052629200', '5052629201', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1417281171', 0, 'N', 0, '2012-05-25', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000512', 'ABQ000512', 'NM01', 'ABQ Health Partners', 'Matthew', '', 'Fitch', 'PA-C', 'Family Practice', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052629200', '5052629201', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052629200', '5052629201', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1417281171', 0, 'N', 0, '2012-05-25', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000113', 'ABQ000113', 'NM01', 'ABQ Health Partners', 'Jeremiah', '', 'Francis', 'PA-C', 'Family Practice', '', '', NULL, 'O', '5150 Journal Center Blvd NE', 'Albuquerque', 'Bernalillo', 'NM', '87109', '5052623212', '5052623381', '5150 Journal Center Blvd NE', 'Albuquerque', 'Bernalillo', 'NM', '87109', '5052623212', '5052623381', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2012-04-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1699000752', 0, 'N', 0, '2013-02-06', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000913', 'ABQ000913', 'NM01', 'ABQ Health Partners', 'Jeremiah', '', 'Francis', 'PA-C', 'Family Practice', '', '', NULL, 'O', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052627110', '5052627829', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052627110', '5052627829', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2013-01-06', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1699000752', 0, 'N', 0, '2013-02-06', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000513', 'ABQ000513', 'NM01', 'ABQ Health Partners', 'Jeremiah', '', 'Francis', 'PA-C', 'Family Practice', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052623212', '5052623381', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052623212', '5052623381', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1699000752', 0, 'N', 0, '2013-02-06', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000346', 'ABQ000346', 'NM01', 'ABQ Health Partners', 'Michelle', '', 'Underwood', 'PA-C', 'Obstetrics and Gynecology', '', '', NULL, 'O', '4705 Montgomery Blvd NE Ste 301-302', 'Albuquerque', 'Bernalillo', 'NM', '87109', '5052546500', '5052546532', '4705 Montgomery Blvd NE Ste 301-302', 'Albuquerque', 'Bernalillo', 'NM', '87109', '5052546500', '5052546532', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2013-09-03', 0, 0, 0, 'Lovelace Womens Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1700811783', 0, 'N', 0, '2013-09-09', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ001146', 'ABQ001146', 'NM01', 'ABQ Health Partners', 'Michelle', '', 'Underwood', 'PA-C', 'Obstetrics and Gynecology', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052546500', '5052546532', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052546500', '5052546532', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Womens Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1700811783', 0, 'N', 0, '2013-09-09', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000746', 'ABQ000746', 'NM01', 'ABQ Health Partners', 'Michelle', '', 'Underwood', 'PA-C', 'Obstetrics and Gynecology', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052546500', '5052546532', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052546500', '5052546532', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Womens Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1700811783', 0, 'N', 0, '2013-09-09', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000114', 'ABQ000114', 'NM01', 'ABQ Health Partners', 'John', '', 'Franklin', 'MD', 'Family Practice', '', '', NULL, 'O', '200 Rio Bravo Blvd SE', 'Albuquerque', 'Bernalillo', 'NM', '87105', '5058736400', '5058736403', '200 Rio Bravo Blvd SE', 'Albuquerque', 'Bernalillo', 'NM', '87105', '5058736400', '5058736403', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2013-05-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1043360035', 0, 'N', 0, '2013-04-30', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000914', 'ABQ000914', 'NM01', 'ABQ Health Partners', 'John', '', 'Franklin', 'MD', 'Family Practice', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5058736400', '5058736403', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5058736400', '5058736403', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2013-05-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1043360035', 0, 'N', 0, '2013-04-30', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000514', 'ABQ000514', 'NM01', 'ABQ Health Partners', 'John', '', 'Franklin', 'MD', 'Family Practice', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5058736400', '5058736403', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5058736400', '5058736403', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2013-05-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1043360035', 0, 'N', 0, '2013-04-30', NULL, NULL, 0, 0, NULL, NULL);
INSERT INTO `providers_new` (`Provider_Tax_ID`, `Provider_Suffix`, `Provider_Network_ID`, `Provider_Region`, `Provider_Name`, `Provider_Doctor_First_Name`, `Provider_Doctor_Middle_Name`, `Provider_Doctor_Last_Name`, `Provider_Doctor_Degree`, `Provider_Specialty_1`, `Provider_Specialty_2`, `Provider_Specialty_3`, `Provider_Specialty_4`, `Provider_Address_Type`, `Provider_Address`, `Provider_City`, `Provider_County`, `Provider_State`, `Provider_Zip`, `Provider_Phone`, `Provider_Fax`, `Provider_Mailing_Address`, `Provider_Mailing_City`, `Provider_Mailing_County`, `Provider_Mailing_State`, `Provider_Mailing_Zip`, `Provider_Mailing_Phone`, `Provider_Mailing_Fax`, `Provider_Primary_Schedule`, `Provider_Secondary_Schedule`, `Provider_Rate_Sheet`, `Provider_Anes_Rate`, `Provider_Default_Rate`, `Provider_Max_DOS`, `Provider_Min_Match_Value`, `Provider_Effective_Date`, `Provider_Term_Date`, `Provider_Pend`, `Provider_Anes_Minutes`, `Provider_PPO`, `Provider_Hospital_1`, `Provider_Hospital_2`, `Provider_Hospital_3`, `Provider_Hospital_4`, `Provider_Type`, `Provider_NPI`, `Provider_Check_Override`, `Exclude_Dir`, `Audit_Status`, `Last_Change_Date`, `Medicare_ID`, `Provider_Lang`, `Provider_Latitude`, `Provider_Longitude`, `Provider_school`, `Provider_cert`) VALUES
('204043287', 'ABQ000115', 'ABQ000115', 'NM01', 'ABQ Health Partners', 'Irwin', '', 'Gabay', 'MD', 'Pediatrics', '', '', NULL, 'O', '5150 Journal Center Blvd NE', 'Albuquerque', 'Bernalillo', 'NM', '87109', '5052623219', '5052623243', '5150 Journal Center Blvd NE', 'Albuquerque', 'Bernalillo', 'NM', '87109', '5052623219', '5052623243', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2012-01-27', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1821073396', 0, 'N', 0, '2012-02-16', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000915', 'ABQ000915', 'NM01', 'ABQ Health Partners', 'Irwin', '', 'Gabay', 'MD', 'Pediatrics', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052623219', '5052623243', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052623219', '5052623243', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2012-01-27', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1821073396', 0, 'N', 0, '2012-02-16', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000515', 'ABQ000515', 'NM01', 'ABQ Health Partners', 'Irwin', '', 'Gabay', 'MD', 'Pediatrics', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052623219', '5052623243', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052623219', '5052623243', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2012-01-27', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1821073396', 0, 'N', 0, '2012-02-16', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000116', 'ABQ000116', 'NM01', 'ABQ Health Partners', 'Ximena', '', 'Galarza-Rios', 'MD', 'Family Practice', '', '', NULL, 'O', '2929 Coors Blvd NW Ste 200', 'Albuquerque', 'Bernalillo', 'NM', '87120', '5058392300', '5058392303', '2929 Coors Blvd NW Ste 200', 'Albuquerque', 'Bernalillo', 'NM', '87120', '5058392300', '5058392303', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Westside Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1407879604', 0, 'N', 0, '2011-10-20', NULL, NULL, 35.1168, -106.702, NULL, NULL),
('204043287', 'ABQ000916', 'ABQ000916', 'NM01', 'ABQ Health Partners', 'Ximena', '', 'Galarza-Rios', 'MD', 'Family Practice', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5058392300', '5058392303', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5058392300', '5058392303', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Westside Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1407879604', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000516', 'ABQ000516', 'NM01', 'ABQ Health Partners', 'Ximena', '', 'Galarza-Rios', 'MD', 'Family Practice', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5058392300', '5058392303', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5058392300', '5058392303', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Westside Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1407879604', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000117', 'ABQ000117', 'NM01', 'ABQ Health Partners', 'Myrna', '', 'Gallegos', 'NP', 'Family Practice', '', '', NULL, 'O', '2929 Coors Blvd NW Ste 200', 'Albuquerque', 'Bernalillo', 'NM', '87120', '5058392300', '5058392303', '2929 Coors Blvd NW Ste 200', 'Albuquerque', 'Bernalillo', 'NM', '87120', '5058392300', '5058392303', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Westside Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1194748202', 0, 'N', 0, '2011-10-20', NULL, NULL, 35.1168, -106.702, NULL, NULL),
('204043287', 'ABQ000917', 'ABQ000917', 'NM01', 'ABQ Health Partners', 'Myrna', '', 'Gallegos', 'NP', 'Family Practice', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5058392300', '5058392303', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5058392300', '5058392303', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Westside Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1194748202', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000517', 'ABQ000517', 'NM01', 'ABQ Health Partners', 'Myrna', '', 'Gallegos', 'NP', 'Family Practice', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5058392300', '5058392303', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5058392300', '5058392303', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Westside Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1194748202', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000118', 'ABQ000118', 'NM01', 'ABQ Health Partners', 'Nishiena', '', 'Gandhi', 'MD', 'Neurology', '', '', NULL, 'O', '5400 Gibson Blvd SE', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052627250', '5052627946', '5400 Gibson Blvd SE', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052627250', '5052627946', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1669527438', 0, 'N', 0, '2011-10-20', NULL, NULL, 35.0583, -106.582, NULL, NULL),
('204043287', 'ABQ000518', 'ABQ000518', 'NM01', 'ABQ Health Partners', 'Nishiena', '', 'Gandhi', 'MD', 'Neurology', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052627250', '5052627946', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052627250', '5052627946', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1669527438', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000119', 'ABQ000119', 'NM01', 'ABQ Health Partners', 'Jodie', '', 'Garcia', 'NP', 'Pediatrics', '', '', NULL, 'O', '1721 Rio Rancho Blvd SE', 'Rio Rancho', 'Sandoval', 'NM', '87124', '5058968600', '5057273505', '1721 Rio Rancho Blvd SE', 'Rio Rancho', 'Sandoval', 'NM', '87124', '5058968600', '5057273505', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1508847344', 0, 'N', 0, '2011-10-20', NULL, NULL, 35.2284, -106.66, NULL, NULL),
('204043287', 'ABQ000919', 'ABQ000919', 'NM01', 'ABQ Health Partners', 'Jodie', '', 'Garcia', 'NP', 'Pediatrics', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5058968600', '5057273505', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5058968600', '5057273505', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1508847344', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000519', 'ABQ000519', 'NM01', 'ABQ Health Partners', 'Jodie', '', 'Garcia', 'NP', 'Pediatrics', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5058968600', '5057273505', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5058968600', '5057273505', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1508847344', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000120', 'ABQ000120', 'NM01', 'ABQ Health Partners', 'Michael', '', 'Garcia', 'MD', 'Family Practice', '', '', NULL, 'O', '200 Rio Bravo Blvd SE', 'Albuquerque', 'Bernalillo', 'NM', '87105', '5058736400', '5058736403', '200 Rio Bravo Blvd SE', 'Albuquerque', 'Bernalillo', 'NM', '87105', '5058736400', '5058736403', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1700947744', 0, 'N', 0, '2011-10-20', NULL, NULL, 35.027, -106.655, NULL, NULL),
('204043287', 'ABQ000920', 'ABQ000920', 'NM01', 'ABQ Health Partners', 'Michael', '', 'Garcia', 'MD', 'Family Practice', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5058736400', '5058736403', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5058736400', '5058736403', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1700947744', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000520', 'ABQ000520', 'NM01', 'ABQ Health Partners', 'Michael', '', 'Garcia', 'MD', 'Family Practice', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5058736400', '5058736403', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5058736400', '5058736403', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1700947744', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ001147', 'ABQ001147', 'NM01', 'ABQ Health Partners', 'Lorene', '', 'Valdez-Boyle', 'MD', 'General Surgery', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052627281', '5052627622', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052627281', '5052627622', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2012-04-18', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1780650986', 0, 'N', 0, '2012-04-19', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000347', 'ABQ000347', 'NM01', 'ABQ Health Partners', 'Lorene', '', 'Valdez-Boyle', 'MD', 'General Surgery', '', '', NULL, 'O', '715 Dr Martin Luther King Jr Ave NE Ste 301', 'Albuquerque', 'Bernalillo', 'NM', '87102', '5052627281', '5052627622', '715 Dr Martin Luther King Jr Ave NE Ste 301', 'Albuquerque', 'Bernalillo', 'NM', '87102', '5052627281', '5052627622', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2012-04-18', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1780650986', 0, 'N', 0, '2012-04-19', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000747', 'ABQ000747', 'NM01', 'ABQ Health Partners', 'Lorene', '', 'Valdez-Boyle', 'MD', 'General Surgery', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052627281', '5052627622', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052627281', '5052627622', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2012-04-18', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1780650986', 0, 'N', 0, '2012-04-19', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000345', 'ABQ000345', 'NM01', 'ABQ Health Partners', 'Aleksandr', '', 'Tsigelnitskiy', 'CNP', 'Hospitalist', '', '', NULL, 'O', '500 Walter St NE Ste 401', 'Albuquerque', 'Bernalillo', 'NM', '87102', '5057278039', '5057278086', '500 Walter St NE Ste 401', 'Albuquerque', 'Bernalillo', 'NM', '87102', '5057278039', '5057278086', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Medical Center', 'Lovelace Womens Hospital', 'Lovelace Westside Hospital ', NULL, 'HCFA|UB|', '1518264308', 0, 'N', 0, '2014-06-13', NULL, NULL, 35.0863, -106.64, NULL, NULL),
('204043287', 'ABQ001145', 'ABQ001145', 'NM01', 'ABQ Health Partners', 'Aleksandr', '', 'Tsigelnitskiy', 'CNP', 'Hospitalist', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5057278039', '5057278086', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5057278039', '5057278086', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Medical Center', 'Lovelace Womens Hospital', 'Lovelace Westside Hospital ', NULL, 'HCFA|UB|', '1518264308', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000745', 'ABQ000745', 'NM01', 'ABQ Health Partners', 'Aleksandr', '', 'Tsigelnitskiy', 'CNP', 'Hospitalist', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5057278039', '5057278086', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5057278039', '5057278086', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Medical Center', 'Lovelace Womens Hospital', 'Lovelace Westside Hospital ', NULL, 'HCFA|UB|', '1518264308', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ001144', 'ABQ001144', 'NM01', 'ABQ Health Partners', 'Ming Chu', '', 'Tsai', 'PA-C', 'General Surgery', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052627281', '5052627622', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052627281', '5052627622', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2012-08-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1881913887', 0, 'N', 0, '2012-08-22', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000344', 'ABQ000344', 'NM01', 'ABQ Health Partners', 'Ming Chu', '', 'Tsai', 'PA-C', 'General Surgery', '', '', NULL, 'O', '715 Dr Martin Luther King Jr Ave NE Ste 301', 'Albuquerque', 'Bernalillo', 'NM', '87102', '5052627281', '5052627622', '715 Dr Martin Luther King Jr Ave NE Ste 301', 'Albuquerque', 'Bernalillo', 'NM', '87102', '5052627281', '5052627622', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2012-08-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1881913887', 0, 'N', 0, '2012-08-22', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000744', 'ABQ000744', 'NM01', 'ABQ Health Partners', 'Ming Chu', '', 'Tsai', 'PA-C', 'General Surgery', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052627281', '5052627622', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052627281', '5052627622', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2012-08-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1881913887', 0, 'N', 0, '2012-08-22', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000921', 'ABQ000921', 'NM01', 'ABQ Health Partners', 'Christopher', '', 'Gavaldon', 'PA-C', 'General Surgery', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052627281', '5052627622', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052627281', '5052627622', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2013-03-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1447345624', 0, 'N', 0, '2013-06-21', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000121', 'ABQ000121', 'NM01', 'ABQ Health Partners', 'Christopher', '', 'Gavaldon', 'PA-C', 'General Surgery', '', '', NULL, 'O', '715 Dr Martin Luther King Jr Ave NE Ste 301', 'Albuquerque', 'Bernalillo', 'NM', '87102', '5052627281', '5052627622', '715 Dr Martin Luther King Jr Ave NE Ste 301', 'Albuquerque', 'Bernalillo', 'NM', '87102', '5052627281', '5052627622', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2013-03-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1447345624', 0, 'N', 0, '2013-06-21', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000521', 'ABQ000521', 'NM01', 'ABQ Health Partners', 'Christopher', '', 'Gavaldon', 'PA-C', 'General Surgery', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052627281', '5052627622', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052627281', '5052627622', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2013-03-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1447345624', 0, 'N', 0, '2013-06-21', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000125', 'ABQ000125', 'NM01', 'ABQ Health Partners', 'Samira', '', 'Ghoreishi', 'PA-C', 'Urgent Care', '', '', NULL, 'O', '1721 Rio Rancho Blvd SE', 'Rio Rancho', 'Sandoval', 'NM', '87124', '5058968604', '5058968697', '1721 Rio Rancho Blvd SE', 'Rio Rancho', 'Sandoval', 'NM', '87124', '5058968604', '5058968697', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2012-02-17', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1477717635', 0, 'Y', 0, '2012-03-05', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000343', 'ABQ000343', 'NM01', 'ABQ Health Partners', 'Joseph', '', 'Tran', 'DO', 'Hospitalist', '', '', NULL, 'O', '500 Walter St NE Ste 401', 'Albuquerque', 'Bernalillo', 'NM', '87102', '5057278039', '5057278086', '500 Walter St NE Ste 401', 'Albuquerque', 'Bernalillo', 'NM', '87102', '5057278039', '5057278086', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Medical Center', 'Lovelace Womens Hospital', 'Lovelace Westside Hospital ', NULL, 'HCFA|UB|', '1790753093', 0, 'N', 0, '2014-06-13', NULL, NULL, 35.0863, -106.64, NULL, NULL),
('204043287', 'ABQ001143', 'ABQ001143', 'NM01', 'ABQ Health Partners', 'Joseph', '', 'Tran', 'DO', 'Hospitalist', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5057278039', '5057278086', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5057278039', '5057278086', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Medical Center', 'Lovelace Womens Hospital', 'Lovelace Westside Hospital ', NULL, 'HCFA|UB|', '1790753093', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000743', 'ABQ000743', 'NM01', 'ABQ Health Partners', 'Joseph', '', 'Tran', 'DO', 'Hospitalist', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5057278039', '5057278086', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5057278039', '5057278086', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Medical Center', 'Lovelace Womens Hospital', 'Lovelace Westside Hospital ', NULL, 'HCFA|UB|', '1790753093', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000922', 'ABQ000922', 'NM01', 'ABQ Health Partners', 'Samira', '', 'Ghoreishi', 'PA-C', 'Urgent Care', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5058968604', '5058968697', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5058968604', '5058968697', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2012-02-17', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1477717635', 0, 'Y', 0, '2012-03-05', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000522', 'ABQ000522', 'NM01', 'ABQ Health Partners', 'Samira', '', 'Ghoreishi', 'PA-C', 'Urgent Care', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5058968604', '5058968697', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5058968604', '5058968697', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2012-02-17', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1477717635', 0, 'N', 0, '2012-03-05', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000342', 'ABQ000342', 'NM01', 'ABQ Health Partners', 'Donny', '', 'Tran', 'MD', 'Family Practice', '', '', NULL, 'O', '3901 Carlisle Blvd NE', 'Albuquerque', 'Bernalillo', 'NM', '87107', '5058888500', '5058888503', '3901 Carlisle Blvd NE', 'Albuquerque', 'Bernalillo', 'NM', '87107', '5058888500', '5058888503', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2014-01-02', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1649319666', 0, 'N', 0, '2013-12-10', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ001142', 'ABQ001142', 'NM01', 'ABQ Health Partners', 'Donny', '', 'Tran', 'MD', 'Family Practice', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5058888500', '5058888503', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5058888500', '5058888503', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2014-01-02', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1649319666', 0, 'N', 0, '2013-12-10', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000742', 'ABQ000742', 'NM01', 'ABQ Health Partners', 'Donny', '', 'Tran', 'MD', 'Family Practice', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5058888500', '5058888503', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5058888500', '5058888503', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2014-01-02', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1649319666', 0, 'N', 0, '2013-12-10', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000926', 'ABQ000926', 'NM01', 'ABQ Health Partners', 'Val', '', 'Gieri', 'MD', 'Family Practice', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052754288', '5052754203', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052754288', '5052754203', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Womens Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1447284641', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000126', 'ABQ000126', 'NM01', 'ABQ Health Partners', 'Val', '', 'Gieri', 'MD', 'Family Practice', '', '', NULL, 'O', '9101 Montgomery Blvd NE', 'Albuquerque', 'Bernalillo', 'NM', '87111', '5052754288', '5052754203', '9101 Montgomery Blvd NE', 'Albuquerque', 'Bernalillo', 'NM', '87111', '5052754288', '5052754203', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Womens Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1447284641', 0, 'N', 0, '2011-10-20', NULL, NULL, 35.1307, -106.542, NULL, NULL),
('204043287', 'ABQ000526', 'ABQ000526', 'NM01', 'ABQ Health Partners', 'Val', '', 'Gieri', 'MD', 'Family Practice', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052754288', '5052754203', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052754288', '5052754203', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Womens Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1447284641', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000130', 'ABQ000130', 'NM01', 'ABQ Health Partners', 'Robert', '', 'Gilbert', 'CNP', 'Urgent Care', '', '', NULL, 'O', '9101 Montgomery Blvd NE', 'Albuquerque', 'Bernalillo', 'NM', '87111', '5052754259', '5052754223', '9101 Montgomery Blvd NE', 'Albuquerque', 'Bernalillo', 'NM', '87111', '5052754259', '5052754223', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Womens Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1063435303', 0, 'Y', 0, '2012-01-17', NULL, NULL, 35.1307, -106.542, NULL, NULL),
('204043287', 'ABQ000927', 'ABQ000927', 'NM01', 'ABQ Health Partners', 'Robert', '', 'Gilbert', 'CNP', 'Urgent Care', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5058968604', '5058968697', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5058968604', '5058968697', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Womens Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1063435303', 0, 'Y', 0, '2012-01-17', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000527', 'ABQ000527', 'NM01', 'ABQ Health Partners', 'Robert', '', 'Gilbert', 'CNP', 'Urgent Care', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5058968604', '5058968697', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5058968604', '5058968697', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Womens Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1063435303', 0, 'N', 0, '2012-01-17', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000131', 'ABQ000131', 'NM01', 'ABQ Health Partners', 'Christine', '', 'Gilmore', 'CNP', 'Pain Management', '', '', NULL, 'O', '5310 Homestead Rd NE Ste 201', 'Albuquerque', 'Bernalillo', 'NM', '87110', '5052627724', '5052623476', '5310 Homestead Rd NE Ste 201', 'Albuquerque', 'Bernalillo', 'NM', '87110', '5052627724', '5052623476', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2012-08-10', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1851686356', 0, 'N', 0, '2012-08-29', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000931', 'ABQ000931', 'NM01', 'ABQ Health Partners', 'Christine', '', 'Gilmore', 'CNP', 'Pain Management', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052627724', '5052623476', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052627724', '5052623476', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2012-08-10', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1851686356', 0, 'N', 0, '2012-08-29', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000531', 'ABQ000531', 'NM01', 'ABQ Health Partners', 'Christine', '', 'Gilmore', 'CNP', 'Pain Management', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052627724', '5052623476', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052627724', '5052623476', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2012-08-10', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1851686356', 0, 'N', 0, '2012-08-29', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000132', 'ABQ000132', 'NM01', 'ABQ Health Partners', 'Patricia', '', 'Glasrud', 'CDE', 'Diabetic Education', '', '', NULL, 'O', '5400 Gibson Blvd SE', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052627455', '5052623955', '5400 Gibson Blvd SE', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052627455', '5052623955', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2014-03-03', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1548293111', 0, 'N', 0, '2014-04-29', NULL, NULL, 35.0583, -106.582, NULL, NULL),
('204043287', 'ABQ000532', 'ABQ000532', 'NM01', 'ABQ Health Partners', 'Patricia', '', 'Glasrud', 'CDE', 'Diabetic Education', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052627455', '5052623955', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052627455', '5052623955', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1548293111', 0, 'N', 0, '2014-04-29', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000134', 'ABQ000134', 'NM01', 'ABQ Health Partners', 'Jeremy', '', 'Gleeson', 'MD', 'Endocrinology', '', '', NULL, 'O', '500 Walter St NE Ste 301', 'Albuquerque', 'Bernalillo', 'NM', '87102', '5052623851', '5052627040', '500 Walter St NE Ste 301', 'Albuquerque', 'Bernalillo', 'NM', '87102', '5052623851', '5052627040', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1215960893', 0, 'N', 0, '2011-10-20', NULL, NULL, 35.0863, -106.64, NULL, NULL),
('204043287', 'ABQ000533', 'ABQ000533', 'NM01', 'ABQ Health Partners', 'Jeremy', '', 'Gleeson', 'MD', 'Endocrinology', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052623851', '5052627040', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052623851', '5052627040', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1215960893', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ001141', 'ABQ001141', 'NM01', 'ABQ Health Partners', 'Nancy', '', 'Tramil', 'MD', 'Family Practice', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052754288', '5052754203', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052754288', '5052754203', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1396768677', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000341', 'ABQ000341', 'NM01', 'ABQ Health Partners', 'Nancy', '', 'Tramil', 'MD', 'Family Practice', '', '', NULL, 'O', '9101 Montgomery Blvd NE', 'Albuquerque', 'Bernalillo', 'NM', '87111', '5052754288', '5052754203', '9101 Montgomery Blvd NE', 'Albuquerque', 'Bernalillo', 'NM', '87111', '5052754288', '5052754203', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1396768677', 0, 'N', 0, '2011-10-20', NULL, NULL, 35.1307, -106.542, NULL, NULL),
('204043287', 'ABQ000741', 'ABQ000741', 'NM01', 'ABQ Health Partners', 'Nancy', '', 'Tramil', 'MD', 'Family Practice', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052754288', '5052754203', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052754288', '5052754203', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1396768677', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000135', 'ABQ000135', 'NM01', 'ABQ Health Partners', 'Jan', '', 'Goldthwait', 'MD', 'Internal Medicine', '', '', NULL, 'O', '5150 Journal Ctr Blvd NE', 'Albuquerque', 'Bernalillo', 'NM', '87109', '5052623212', '5052623381', '5150 Journal Center Blvd NE', 'Albuquerque', 'Bernalillo', 'NM', '87109', '5052623212', '5052623381', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1538275672', 0, 'N', 0, '2011-10-20', NULL, NULL, 35.1702, -106.586, NULL, NULL),
('204043287', 'ABQ000935', 'ABQ000935', 'NM01', 'ABQ Health Partners', 'Jan', '', 'Goldthwait', 'MD', 'Internal Medicine', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052623212', '5052623381', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052623212', '5052623381', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1538275672', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000535', 'ABQ000535', 'NM01', 'ABQ Health Partners', 'Jan', '', 'Goldthwait', 'MD', 'Internal Medicine', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052623212', '5052623381', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052623212', '5052623381', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1538275672', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000936', 'ABQ000936', 'NM01', 'ABQ Health Partners', 'Alyssa', '', 'Gonzales', 'PA-C', 'Pediatrics', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052623219', '5052623243', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052623219', '5052623243', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Westside Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1992990436', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000536', 'ABQ000536', 'NM01', 'ABQ Health Partners', 'Alyssa', '', 'Gonzales', 'PA-C', 'Pediatrics', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052623219', '5052623243', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052623219', '5052623243', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Westside Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1992990436', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000138', 'ABQ000138', 'NM01', 'ABQ Health Partners', 'John', '', 'Good', 'MD', 'Pediatrics', '', '', NULL, 'O', '1721 Rio Rancho Blvd SE', 'Rio Rancho', 'Sandoval', 'NM', '87124', '5058968600', '5057273505', '1721 Rio Rancho Blvd SE', 'Rio Rancho', 'Sandoval', 'NM', '87124', '5058968600', '5057273505', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Medical Center', 'Lovelace Womens Hospital', 'Lovelace Westside Hospital ', NULL, 'HCFA|UB|', '1417982521', 0, 'N', 0, '2011-10-20', NULL, NULL, 35.2284, -106.66, NULL, NULL),
('204043287', 'ABQ000938', 'ABQ000938', 'NM01', 'ABQ Health Partners', 'John', '', 'Good', 'MD', 'Pediatrics', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5058968600', '5057273505', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5058968600', '5057273505', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Medical Center', 'Lovelace Womens Hospital', 'Lovelace Westside Hospital ', NULL, 'HCFA|UB|', '1417982521', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000538', 'ABQ000538', 'NM01', 'ABQ Health Partners', 'John', '', 'Good', 'MD', 'Pediatrics', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5058968600', '5057273505', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5058968600', '5057273505', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Medical Center', 'Lovelace Womens Hospital', 'Lovelace Westside Hospital ', NULL, 'HCFA|UB|', '1417982521', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000139', 'ABQ000139', 'NM01', 'ABQ Health Partners', 'Jennifer', '', 'Graff', 'MD', 'Obstetrics and Gynecology', '', '', NULL, 'O', '4705 Montgomery Blvd NE Ste 301-302', 'Albuquerque', 'Bernalillo', 'NM', '87109', '5052546500', '5052546532', '4705 Montgomery Blvd NE Ste 301-302', 'Albuquerque', 'Bernalillo', 'NM', '87109', '5052546500', '5052546532', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2012-06-15', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1114108347', 0, 'N', 0, '2012-07-05', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000939', 'ABQ000939', 'NM01', 'ABQ Health Partners', 'Jennifer', '', 'Graff', 'MD', 'Obstetrics and Gynecology', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052546500', '5052546532', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052546500', '5052546532', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2012-06-15', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1114108347', 0, 'N', 0, '2012-07-05', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000539', 'ABQ000539', 'NM01', 'ABQ Health Partners', 'Jennifer', '', 'Graff', 'MD', 'Obstetrics and Gynecology', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052546500', '5052546532', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052546500', '5052546532', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2012-06-15', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1114108347', 0, 'N', 0, '2012-07-05', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000140', 'ABQ000140', 'NM01', 'ABQ Health Partners', 'John', '', 'Graham', 'MD', 'Ophthalmology', '', '', NULL, 'O', '5400 Gibson Blvd SE', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052623937', '5052627147', '5400 Gibson Blvd SE', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052623937', '5052627147', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2012-02-29', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1104851187', 0, 'N', 0, '2012-03-05', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000540', 'ABQ000540', 'NM01', 'ABQ Health Partners', 'John', '', 'Graham', 'MD', 'Ophthalmology', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052623937', '5052627147', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052623937', '5052627147', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2012-02-29', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1104851187', 0, 'N', 0, '2012-03-05', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000141', 'ABQ000141', 'NM01', 'ABQ Health Partners', 'Jack', '', 'Greenberg', 'MD', 'Family Practice', '', '', NULL, 'O', '2121 Juan Tabo Blvd NE', 'Albuquerque', 'Bernalillo', 'NM', '87112', '5052378800', '5052378817', '2121 Juan Tabo Blvd NE', 'Albuquerque', 'Bernalillo', 'NM', '87112', '5052378800', '5052378817', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1366465460', 0, 'N', 0, '2011-10-20', NULL, NULL, 35.1062, -106.516, NULL, NULL),
('204043287', 'ABQ000941', 'ABQ000941', 'NM01', 'ABQ Health Partners', 'Jack', '', 'Greenberg', 'MD', 'Family Practice', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052378800', '5052378817', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052378800', '5052378817', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1366465460', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000541', 'ABQ000541', 'NM01', 'ABQ Health Partners', 'Jack', '', 'Greenberg', 'MD', 'Family Practice', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052378800', '5052378817', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052378800', '5052378817', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1366465460', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000142', 'ABQ000142', 'NM01', 'ABQ Health Partners', 'Timothy', '', 'Grenemyer', 'DO', 'Family Practice', '', '', NULL, 'O', '1901 Juan Tabo Blvd NE', 'Albuquerque', 'Bernalillo', 'NM', '87112', '5052629200', '5052629201', '1901 Juan Tabo Blvd NE', 'Albuquerque', 'Bernalillo', 'NM', '87112', '5052629200', '5052629201', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Medical Center', 'Lovelace Womens Hospital', 'Lovelace Westside Hospital ', NULL, 'HCFA|UB|', '1588699391', 0, 'N', 0, '2011-10-20', NULL, NULL, 35.1032, -106.516, NULL, NULL),
('204043287', 'ABQ000942', 'ABQ000942', 'NM01', 'ABQ Health Partners', 'Timothy', '', 'Grenemyer', 'DO', 'Family Practice', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052629200', '5052629201', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052629200', '5052629201', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Medical Center', 'Lovelace Womens Hospital', 'Lovelace Westside Hospital ', NULL, 'HCFA|UB|', '1588699391', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000542', 'ABQ000542', 'NM01', 'ABQ Health Partners', 'Timothy', '', 'Grenemyer', 'DO', 'Family Practice', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052629200', '5052629201', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052629200', '5052629201', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Medical Center', 'Lovelace Womens Hospital', 'Lovelace Westside Hospital ', NULL, 'HCFA|UB|', '1588699391', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000143', 'ABQ000143', 'NM01', 'ABQ Health Partners', 'Cynthia', '', 'Griebler', 'MD', 'Hospitalist', '', '', NULL, 'O', '500 Walter St NE Ste 401', 'Albuquerque', 'Bernalillo', 'NM', '87102', '5057278039', '5057278086', '500 Walter St NE Ste 401', 'Albuquerque', 'Bernalillo', 'NM', '87102', '5057278039', '5057278086', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Medical Center', 'Lovelace Womens Hospital', 'Lovelace Westside Hospital ', NULL, 'HCFA|UB|', '1750316865', 0, 'N', 0, '2014-06-13', NULL, NULL, 35.0863, -106.64, NULL, NULL),
('204043287', 'ABQ000943', 'ABQ000943', 'NM01', 'ABQ Health Partners', 'Cynthia', '', 'Griebler', 'MD', 'Hospitalist', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5057278039', '5057278086', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5057278039', '5057278086', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Medical Center', 'Lovelace Womens Hospital', 'Lovelace Westside Hospital ', NULL, 'HCFA|UB|', '1750316865', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000543', 'ABQ000543', 'NM01', 'ABQ Health Partners', 'Cynthia', '', 'Griebler', 'MD', 'Hospitalist', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5057278039', '5057278086', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5057278039', '5057278086', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Medical Center', 'Lovelace Womens Hospital', 'Lovelace Westside Hospital ', NULL, 'HCFA|UB|', '1750316865', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000147', 'ABQ000147', 'NM01', 'ABQ Health Partners', 'Raul', '', 'Griego', 'MD', 'Urgent Care', '', '', NULL, 'O', '1721 Rio Rancho Blvd SE', 'Rio Rancho', 'Sandoval', 'NM', '87124', '5058968604', '5058968697', '1721 Rio Rancho Blvd SE', 'Rio Rancho', 'Sandoval', 'NM', '87124', '5058968604', '5058968697', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Womens Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1245248814', 0, 'Y', 0, '2012-01-17', NULL, NULL, 35.2284, -106.66, NULL, NULL),
('204043287', 'ABQ000944', 'ABQ000944', 'NM01', 'ABQ Health Partners', 'Raul', '', 'Griego', 'MD', 'Urgent Care', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5058968604', '5058968697', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5058968604', '5058968697', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Womens Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1245248814', 0, 'Y', 0, '2012-01-17', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000544', 'ABQ000544', 'NM01', 'ABQ Health Partners', 'Raul', '', 'Griego', 'MD', 'Urgent Care', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5058968604', '5058968697', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5058968604', '5058968697', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Womens Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1245248814', 0, 'N', 0, '2012-01-17', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000148', 'ABQ000148', 'NM01', 'ABQ Health Partners', 'Peter', '', 'Guido', 'MD', 'Sleep Medicine', '', '', NULL, 'O', '4700 Jefferson St NE Ste 800', 'Albuquerque', 'Bernalillo', 'NM', '87109', '5058726000', '5058726003', '4700 Jefferson St NE Ste 800', 'Albuquerque', 'Bernalillo', 'NM', '87109', '5058726000', '5058726003', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1003839119', 0, 'N', 0, '2011-10-20', NULL, NULL, 35.1342, -106.593, NULL, NULL),
('204043287', 'ABQ000948', 'ABQ000948', 'NM01', 'ABQ Health Partners', 'Peter', '', 'Guido', 'MD', 'Sleep Medicine', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5058726000', '5058726003', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5058726000', '5058726003', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1003839119', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000548', 'ABQ000548', 'NM01', 'ABQ Health Partners', 'Peter', '', 'Guido', 'MD', 'Sleep Medicine', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5058726000', '5058726003', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5058726000', '5058726003', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1003839119', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000149', 'ABQ000149', 'NM01', 'ABQ Health Partners', 'Kristina', '', 'Gutierrez-Barela', 'MD', 'Pediatrics', '', '', NULL, 'O', '1721 Rio Rancho Blvd SE', 'Rio Rancho', 'Sandoval', 'NM', '87124', '5058968600', '5057273505', '1721 Rio Rancho Blvd SE', 'Rio Rancho', 'Sandoval', 'NM', '87124', '5058968600', '5057273505', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Medical Center', 'Lovelace Westside Hospital', NULL, NULL, 'HCFA|UB|', '1104859768', 0, 'N', 0, '2011-10-20', NULL, NULL, 35.2284, -106.66, NULL, NULL),
('204043287', 'ABQ000949', 'ABQ000949', 'NM01', 'ABQ Health Partners', 'Kristina', '', 'Gutierrez-Barela', 'MD', 'Pediatrics', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5058968600', '5057273505', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5058968600', '5057273505', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Medical Center', 'Lovelace Westside Hospital', NULL, NULL, 'HCFA|UB|', '1104859768', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000549', 'ABQ000549', 'NM01', 'ABQ Health Partners', 'Kristina', '', 'Gutierrez-Barela', 'MD', 'Pediatrics', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5058968600', '5057273505', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5058968600', '5057273505', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Medical Center', 'Lovelace Westside Hospital', NULL, NULL, 'HCFA|UB|', '1104859768', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000150', 'ABQ000150', 'NM01', 'ABQ Health Partners', 'Patrick', '', 'Haarhues', 'MD', 'Hospitalist', '', '', NULL, 'O', '500 Walter St NE Ste 401', 'Albuquerque', 'Bernalillo', 'NM', '87102', '5057278039', '5057278086', '500 Walter St NE Ste 401', 'Albuquerque', 'Bernalillo', 'NM', '87102', '5057278039', '5057278086', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Medical Center', 'Lovelace Womens Hospital', 'Lovelace Westside Hospital ', NULL, 'HCFA|UB|', '1841403334', 0, 'N', 0, '2014-06-13', NULL, NULL, 35.0863, -106.64, NULL, NULL),
('204043287', 'ABQ000950', 'ABQ000950', 'NM01', 'ABQ Health Partners', 'Patrick', '', 'Haarhues', 'MD', 'Hospitalist', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5057278039', '5057278086', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5057278039', '5057278086', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Medical Center', 'Lovelace Womens Hospital', 'Lovelace Westside Hospital ', NULL, 'HCFA|UB|', '1841403334', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000550', 'ABQ000550', 'NM01', 'ABQ Health Partners', 'Patrick', '', 'Haarhues', 'MD', 'Hospitalist', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5057278039', '5057278086', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5057278039', '5057278086', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Medical Center', 'Lovelace Womens Hospital', 'Lovelace Westside Hospital ', NULL, 'HCFA|UB|', '1841403334', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL);
INSERT INTO `providers_new` (`Provider_Tax_ID`, `Provider_Suffix`, `Provider_Network_ID`, `Provider_Region`, `Provider_Name`, `Provider_Doctor_First_Name`, `Provider_Doctor_Middle_Name`, `Provider_Doctor_Last_Name`, `Provider_Doctor_Degree`, `Provider_Specialty_1`, `Provider_Specialty_2`, `Provider_Specialty_3`, `Provider_Specialty_4`, `Provider_Address_Type`, `Provider_Address`, `Provider_City`, `Provider_County`, `Provider_State`, `Provider_Zip`, `Provider_Phone`, `Provider_Fax`, `Provider_Mailing_Address`, `Provider_Mailing_City`, `Provider_Mailing_County`, `Provider_Mailing_State`, `Provider_Mailing_Zip`, `Provider_Mailing_Phone`, `Provider_Mailing_Fax`, `Provider_Primary_Schedule`, `Provider_Secondary_Schedule`, `Provider_Rate_Sheet`, `Provider_Anes_Rate`, `Provider_Default_Rate`, `Provider_Max_DOS`, `Provider_Min_Match_Value`, `Provider_Effective_Date`, `Provider_Term_Date`, `Provider_Pend`, `Provider_Anes_Minutes`, `Provider_PPO`, `Provider_Hospital_1`, `Provider_Hospital_2`, `Provider_Hospital_3`, `Provider_Hospital_4`, `Provider_Type`, `Provider_NPI`, `Provider_Check_Override`, `Exclude_Dir`, `Audit_Status`, `Last_Change_Date`, `Medicare_ID`, `Provider_Lang`, `Provider_Latitude`, `Provider_Longitude`, `Provider_school`, `Provider_cert`) VALUES
('204043287', 'ABQ000151', 'ABQ000151', 'NM01', 'ABQ Health Partners', 'Jamal', '', 'Haleem', 'MD', 'Hospitalist', '', '', NULL, 'O', '500 Walter St NE Ste 401', 'Albuquerque', 'Bernalillo', 'NM', '87102', '5057278039', '5057278086', '500 Walter St NE Ste 401', 'Albuquerque', 'Bernalillo', 'NM', '87102', '5057278039', '5057278086', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Medical Center', 'Lovelace Womens Hospital', 'Lovelace Westside Hospital ', NULL, 'HCFA|UB|', '1568422079', 0, 'N', 0, '2014-06-13', NULL, NULL, 35.0863, -106.64, NULL, NULL),
('204043287', 'ABQ000951', 'ABQ000951', 'NM01', 'ABQ Health Partners', 'Jamal', '', 'Haleem', 'MD', 'Hospitalist', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5057278039', '5057278086', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5057278039', '5057278086', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Medical Center', 'Lovelace Womens Hospital', 'Lovelace Westside Hospital ', NULL, 'HCFA|UB|', '1568422079', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000551', 'ABQ000551', 'NM01', 'ABQ Health Partners', 'Jamal', '', 'Haleem', 'MD', 'Hospitalist', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5057278039', '5057278086', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5057278039', '5057278086', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Medical Center', 'Lovelace Womens Hospital', 'Lovelace Westside Hospital ', NULL, 'HCFA|UB|', '1568422079', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000952', 'ABQ000952', 'NM01', 'ABQ Health Partners', 'Elisa', '', 'Hall', 'MD', 'Pathology', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5057276450', '5057278391', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5057276450', '5057278391', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2013-08-16', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1255368734', 0, 'N', 0, '2013-09-10', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000152', 'ABQ000152', 'NM01', 'ABQ Health Partners', 'Elisa', '', 'Hall', 'MD', 'Pathology', '', '', NULL, 'O', '601 Dr Martin Luther King Jr Ave NE', 'Albuquerque', 'Bernalillo', 'NM', '87102', '5057276450', '5057278391', '601 Dr Martin Luther King Jr Ave NE', 'Albuquerque', 'Bernalillo', 'NM', '87102', '5057276450', '5057278391', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2013-08-16', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1255368734', 0, 'N', 0, '2013-09-10', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000552', 'ABQ000552', 'NM01', 'ABQ Health Partners', 'Elisa', '', 'Hall', 'MD', 'Pathology', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5057276450', '5057278391', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5057276450', '5057278391', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2013-08-16', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1255368734', 0, 'N', 0, '2013-09-10', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000153', 'ABQ000153', 'NM01', 'ABQ Health Partners', 'David', '', 'Hardwicke', 'MD', 'Internal Medicine', '', '', NULL, 'O', '5150 Journal Ctr Blvd NE', 'Albuquerque', 'Bernalillo', 'NM', '87109', '5052623212', '5052623381', '5150 Journal Center Blvd NE', 'Albuquerque', 'Bernalillo', 'NM', '87109', '5052623212', '5052623381', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1528093648', 0, 'N', 0, '2011-10-20', NULL, NULL, 35.1702, -106.586, NULL, NULL),
('204043287', 'ABQ000953', 'ABQ000953', 'NM01', 'ABQ Health Partners', 'David', '', 'Hardwicke', 'MD', 'Internal Medicine', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052623212', '5052623381', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052623212', '5052623381', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1528093648', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000553', 'ABQ000553', 'NM01', 'ABQ Health Partners', 'David', '', 'Hardwicke', 'MD', 'Internal Medicine', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052623212', '5052623381', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052623212', '5052623381', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1528093648', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000154', 'ABQ000154', 'NM01', 'ABQ Health Partners', 'Julie', '', 'Harrigan', 'MD', 'Hospitalist', '', '', NULL, 'O', '500 Walter St NE Ste 401', 'Albuquerque', 'Bernalillo', 'NM', '87102', '5057278039', '5057278086', '500 Walter St NE Ste 401', 'Albuquerque', 'Bernalillo', 'NM', '87102', '5057278039', '5057278086', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Medical Center', 'Lovelace Womens Hospital', 'Lovelace Westside Hospital ', NULL, 'HCFA|UB|', '1619016656', 0, 'N', 0, '2014-06-13', NULL, NULL, 35.0863, -106.64, NULL, NULL),
('204043287', 'ABQ000954', 'ABQ000954', 'NM01', 'ABQ Health Partners', 'Julie', '', 'Harrigan', 'MD', 'Hospitalist', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5057278039', '5057278086', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5057278039', '5057278086', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Medical Center', 'Lovelace Womens Hospital', 'Lovelace Westside Hospital ', NULL, 'HCFA|UB|', '1619016656', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000554', 'ABQ000554', 'NM01', 'ABQ Health Partners', 'Julie', '', 'Harrigan', 'MD', 'Hospitalist', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5057278039', '5057278086', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5057278039', '5057278086', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Medical Center', 'Lovelace Womens Hospital', 'Lovelace Westside Hospital ', NULL, 'HCFA|UB|', '1619016656', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000155', 'ABQ000155', 'NM01', 'ABQ Health Partners', 'Alice', '', 'Harsh', 'CDE', 'Diabetic Education', '', '', NULL, 'O', '5400 Gibson Blvd SE', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052627455', '5052623955', '5400 Gibson Blvd SE', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052627455', '5052623955', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1639104755', 0, 'N', 0, '2013-09-09', NULL, NULL, 35.0583, -106.582, NULL, NULL),
('204043287', 'ABQ000555', 'ABQ000555', 'NM01', 'ABQ Health Partners', 'Alice', '', 'Harsh', 'CDE', 'Diabetic Education', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052627455', '5052623955', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052627455', '5052623955', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1639104755', 0, 'N', 0, '2013-09-09', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000156', 'ABQ000156', 'NM01', 'ABQ Health Partners', 'Elizabeth', '', 'Heath-West', 'CNM', 'Obstetrics and Gynecology', '', '', NULL, 'O', '5400 Gibson Blvd SE', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052546500', '5052546532', '5400 Gibson Blvd SE', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052546500', '5052546532', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Medical Center', '', '', '', 'HCFA|UB|', '1134152721', 0, 'N', 0, '2014-06-24', NULL, NULL, 35.0583, -106.582, NULL, NULL),
('204043287', 'ABQ000556', 'ABQ000556', 'NM01', 'ABQ Health Partners', 'Elizabeth', '', 'Heath-West', 'CNM', 'Obstetrics and Gynecology', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052546500', '5052546532', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052546500', '5052546532', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Medical Center', '', '', '', 'HCFA|UB|', '1134152721', 0, 'N', 0, '2014-06-24', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000157', 'ABQ000157', 'NM01', 'ABQ Health Partners', 'David', '', 'Hemphill', 'MD', 'Hospitalist', '', '', NULL, 'O', '500 Walter St NE Ste 309', 'Albuquerque', 'Bernalillo', 'NM', '87102', '5057278039', '5057278086', '500 Walter St NE Ste 309', 'Albuquerque', 'Bernalillo', 'NM', '87102', '5057278039', '5057278086', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1699735100', 0, 'N', 0, '2011-10-20', NULL, NULL, 35.0863, -106.64, NULL, NULL),
('204043287', 'ABQ000957', 'ABQ000957', 'NM01', 'ABQ Health Partners', 'David', '', 'Hemphill', 'MD', 'Hospitalist', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5057278039', '5057278086', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5057278039', '5057278086', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1699735100', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000557', 'ABQ000557', 'NM01', 'ABQ Health Partners', 'David', '', 'Hemphill', 'MD', 'Hospitalist', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5057278039', '5057278086', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5057278039', '5057278086', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1699735100', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000158', 'ABQ000158', 'NM01', 'ABQ Health Partners', 'Patricia', '', 'Hendrickson', 'NP', 'Obstetrics and Gynecology', '', '', NULL, 'O', '5150 Journal Ctr Blvd NE', 'Albuquerque', 'Bernalillo', 'NM', '87109', '5052546500', '5052623198', '5150 Journal Center Blvd NE', 'Albuquerque', 'Bernalillo', 'NM', '87109', '5052546500', '5052623198', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Medical Center', 'Lovelace Womens Hospital', NULL, NULL, 'HCFA|UB|', '1912930504', 0, 'N', 0, '2011-10-20', NULL, NULL, 35.1702, -106.586, NULL, NULL),
('204043287', 'ABQ000958', 'ABQ000958', 'NM01', 'ABQ Health Partners', 'Patricia', '', 'Hendrickson', 'NP', 'Obstetrics and Gynecology', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052546500', '5052623198', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052546500', '5052623198', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Medical Center', 'Lovelace Womens Hospital', NULL, NULL, 'HCFA|UB|', '1912930504', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000558', 'ABQ000558', 'NM01', 'ABQ Health Partners', 'Patricia', '', 'Hendrickson', 'NP', 'Obstetrics and Gynecology', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052546500', '5052623198', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052546500', '5052623198', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Medical Center', 'Lovelace Womens Hospital', NULL, NULL, 'HCFA|UB|', '1912930504', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000159', 'ABQ000159', 'NM01', 'ABQ Health Partners', 'Camille', '', 'Hernandez', 'NP', 'Pulmonary', '', '', NULL, 'O', '500 Walter St NE Ste 205', 'Albuquerque', 'Bernalillo', 'NM', '87102', '5052627223', '5052627450', '500 Walter St NE Ste 205', 'Albuquerque', 'Bernalillo', 'NM', '87102', '5052627223', '5052627450', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Medical Center', 'Lovelace Womens Hospital', 'Lovelace Westside Hospital ', NULL, 'HCFA|UB|', '1396956330', 0, 'N', 0, '2012-05-25', NULL, NULL, 35.0863, -106.64, NULL, NULL),
('204043287', 'ABQ000959', 'ABQ000959', 'NM01', 'ABQ Health Partners', 'Camille', '', 'Hernandez', 'NP', 'Pulmonary', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052627223', '5052627450', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052627223', '5052627450', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Medical Center', 'Lovelace Womens Hospital', 'Lovelace Westside Hospital ', NULL, 'HCFA|UB|', '1396956330', 0, 'N', 0, '2012-05-25', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000559', 'ABQ000559', 'NM01', 'ABQ Health Partners', 'Camille', '', 'Hernandez', 'NP', 'Pulmonary', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052627223', '5052627450', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052627223', '5052627450', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Medical Center', 'Lovelace Womens Hospital', 'Lovelace Westside Hospital ', NULL, 'HCFA|UB|', '1396956330', 0, 'N', 0, '2012-05-25', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000960', 'ABQ000960', 'NM01', 'ABQ Health Partners', 'Nathaniel', '', 'Hill', 'DO', 'General Surgery', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052627281', '5052627622', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052627281', '5052627622', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Westside Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1609066026', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000160', 'ABQ000160', 'NM01', 'ABQ Health Partners', 'Nathaniel', '', 'Hill', 'DO', 'General Surgery', '', '', NULL, 'O', '715 Dr Martin Luther King Jr Ave NE Ste 301', 'Albuquerque', 'Bernalillo', 'NM', '87102', '5052627281', '5052627622', '715 Dr Martin Luther King Jr Ave NE Ste 301', 'Albuquerque', 'Bernalillo', 'NM', '87102', '5052627281', '5052627622', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Westside Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1609066026', 0, 'N', 0, '2011-10-20', NULL, NULL, 35.0856, -106.639, NULL, NULL),
('204043287', 'ABQ000560', 'ABQ000560', 'NM01', 'ABQ Health Partners', 'Nathaniel', '', 'Hill', 'DO', 'General Surgery', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052627281', '5052627622', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052627281', '5052627622', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Westside Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1609066026', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000161', 'ABQ000161', 'NM01', 'ABQ Health Partners', 'Mary', '', 'Hill-Matthews', 'MD', 'Family Practice', '', '', NULL, 'O', '2121 Juan Tabo Blvd NE', 'Albuquerque', 'Bernalillo', 'NM', '87112', '5052378800', '5052378817', '2121 Juan Tabo Blvd NE', 'Albuquerque', 'Bernalillo', 'NM', '87112', '5052378800', '5052378817', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1437184553', 0, 'N', 0, '2011-10-20', NULL, NULL, 35.1062, -106.516, NULL, NULL),
('204043287', 'ABQ000961', 'ABQ000961', 'NM01', 'ABQ Health Partners', 'Mary', '', 'Hill-Matthews', 'MD', 'Family Practice', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052378800', '5052378817', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052378800', '5052378817', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1437184553', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000561', 'ABQ000561', 'NM01', 'ABQ Health Partners', 'Mary', '', 'Hill-Matthews', 'MD', 'Family Practice', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052378800', '5052378817', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052378800', '5052378817', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1437184553', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000162', 'ABQ000162', 'NM01', 'ABQ Health Partners', 'Danielle', '', 'Hoelter', 'CNM', 'Obstetrics and Gynecology', '', '', NULL, 'O', '4705 Montgomery Blvd NE Ste 301-302', 'Albuquerque', 'Bernalillo', 'NM', '87109', '5052546500', '5052546532', '4705 Montgomery Blvd NE Ste 301-302', 'Albuquerque', 'Bernalillo', 'NM', '87109', '5052546500', '5052546532', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Womens Hospital', 'Lovelace Westside Hospital', NULL, NULL, 'HCFA|UB|', '1780848648', 0, 'N', 0, '2011-10-20', NULL, NULL, 35.131, -106.591, NULL, NULL),
('204043287', 'ABQ000962', 'ABQ000962', 'NM01', 'ABQ Health Partners', 'Danielle', '', 'Hoelter', 'CNM', 'Obstetrics and Gynecology', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052546500', '5052546532', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052546500', '5052546532', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Womens Hospital', 'Lovelace Westside Hospital', NULL, NULL, 'HCFA|UB|', '1780848648', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000562', 'ABQ000562', 'NM01', 'ABQ Health Partners', 'Danielle', '', 'Hoelter', 'CNM', 'Obstetrics and Gynecology', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052546500', '5052546532', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052546500', '5052546532', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Womens Hospital', 'Lovelace Westside Hospital', NULL, NULL, 'HCFA|UB|', '1780848648', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000963', 'ABQ000963', 'NM01', 'ABQ Health Partners', 'Richard', '', 'Holmes', 'MD', 'General Surgery', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052627281', '5052627622', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052627281', '5052627622', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Westside Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1689666760', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000163', 'ABQ000163', 'NM01', 'ABQ Health Partners', 'Richard', '', 'Holmes', 'MD', 'General Surgery', '', '', NULL, 'O', '715 Dr Martin Luther King Jr Ave NE Ste 301', 'Albuquerque', 'Bernalillo', 'NM', '87102', '5052627281', '5052627622', '715 Dr Martin Luther King Jr Ave NE Ste 301', 'Albuquerque', 'Bernalillo', 'NM', '87102', '5052627281', '5052627622', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Westside Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1689666760', 0, 'N', 0, '2011-10-20', NULL, NULL, 35.0856, -106.639, NULL, NULL),
('204043287', 'ABQ000563', 'ABQ000563', 'NM01', 'ABQ Health Partners', 'Richard', '', 'Holmes', 'MD', 'General Surgery', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052627281', '5052627622', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052627281', '5052627622', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Westside Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1689666760', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000164', 'ABQ000164', 'NM01', 'ABQ Health Partners', 'David', '', 'Holten', 'MD', 'Family Practice', '', '', NULL, 'O', '13701 Encantado Rd NE', 'Albuquerque', 'Bernalillo', 'NM', '87123', '5052378700', '5052378703', '13701 Encantado Rd NE', 'Albuquerque', 'Bernalillo', 'NM', '87123', '5052378700', '5052378703', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1861406605', 0, 'N', 0, '2011-10-20', NULL, NULL, 35.0743, -106.497, NULL, NULL),
('204043287', 'ABQ000964', 'ABQ000964', 'NM01', 'ABQ Health Partners', 'David', '', 'Holten', 'MD', 'Family Practice', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052378700', '5052378703', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052378700', '5052378703', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1861406605', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000564', 'ABQ000564', 'NM01', 'ABQ Health Partners', 'David', '', 'Holten', 'MD', 'Family Practice', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052378700', '5052378703', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052378700', '5052378703', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1861406605', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000165', 'ABQ000165', 'NM01', 'ABQ Health Partners', 'Judith', '', 'Hooffstetter', 'MD', 'Hospitalist', '', '', NULL, 'O', '500 Walter St NE Ste 309', 'Albuquerque', 'Bernalillo', 'NM', '87102', '5057278039', '5057278086', '500 Walter St NE Ste 309', 'Albuquerque', 'Bernalillo', 'NM', '87102', '5057278039', '5057278086', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2012-06-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1114932506', 0, 'N', 0, '2012-06-13', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000965', 'ABQ000965', 'NM01', 'ABQ Health Partners', 'Judith', '', 'Hooffstetter', 'MD', 'Hospitalist', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5057278039', '5057278086', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5057278039', '5057278086', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2012-06-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1114932506', 0, 'N', 0, '2012-06-13', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000565', 'ABQ000565', 'NM01', 'ABQ Health Partners', 'Judith', '', 'Hooffstetter', 'MD', 'Hospitalist', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5057278039', '5057278086', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5057278039', '5057278086', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2012-06-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1114932506', 0, 'N', 0, '2012-06-13', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000166', 'ABQ000166', 'NM01', 'ABQ Health Partners', 'James', '', 'Houle', 'MD', 'Family Practice', '', '', NULL, 'O', '2121 Juan Tabo Blvd NE', 'Albuquerque', 'Bernalillo', 'NM', '87112', '5052378800', '5052378817', '2121 Juan Tabo Blvd NE', 'Albuquerque', 'Bernalillo', 'NM', '87112', '5052378800', '5052378817', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1134154115', 0, 'N', 0, '2011-10-20', NULL, NULL, 35.1062, -106.516, NULL, NULL),
('204043287', 'ABQ000966', 'ABQ000966', 'NM01', 'ABQ Health Partners', 'James', '', 'Houle', 'MD', 'Family Practice', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052378800', '5052378817', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052378800', '5052378817', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1134154115', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000566', 'ABQ000566', 'NM01', 'ABQ Health Partners', 'James', '', 'Houle', 'MD', 'Family Practice', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052378800', '5052378817', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052378800', '5052378817', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1134154115', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000170', 'ABQ000170', 'NM01', 'ABQ Health Partners', 'William', '', 'Hughes', 'DO', 'Urgent Care', '', '', NULL, 'O', '200 Rio Bravo Blvd SE', 'Albuquerque', 'Bernalillo', 'NM', '87105', '5058736401', '5058736408', '200 Rio Bravo Blvd SE', 'Albuquerque', 'Bernalillo', 'NM', '87105', '5058736401', '5058736408', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2012-01-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1619902608', 0, 'Y', 0, '2012-01-17', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000967', 'ABQ000967', 'NM01', 'ABQ Health Partners', 'William', '', 'Hughes', 'DO', 'Urgent Care', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5058968604', '5058968697', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5058968604', '5058968697', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1619902608', 0, 'Y', 0, '2012-01-17', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000567', 'ABQ000567', 'NM01', 'ABQ Health Partners', 'William', '', 'Hughes', 'DO', 'Urgent Care', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5058968604', '5058968697', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5058968604', '5058968697', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1619902608', 0, 'N', 0, '2012-01-17', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000172', 'ABQ000172', 'NM01', 'ABQ Health Partners', 'Linda', '', 'Johnson', 'CNM', 'Obstetrics and Gynecology', '', '', NULL, 'O', '4705 Montgomery Blvd NE Ste 301-302', 'Albuquerque', 'Bernalillo', 'NM', '87109', '5052546500', '5052546532', '4705 Montgomery Blvd NE Ste 301-302', 'Albuquerque', 'Bernalillo', 'NM', '87109', '5052546500', '5052546532', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2012-06-02', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1932134962', 0, 'N', 0, '2012-06-13', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000971', 'ABQ000971', 'NM01', 'ABQ Health Partners', 'Linda', '', 'Johnson', 'CNM', 'Obstetrics and Gynecology', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052546500', '5052546532', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052546500', '5052546532', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2012-06-02', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1932134962', 0, 'N', 0, '2012-06-13', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000571', 'ABQ000571', 'NM01', 'ABQ Health Partners', 'Linda', '', 'Johnson', 'CNM', 'Obstetrics and Gynecology', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052546500', '5052546532', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052546500', '5052546532', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2012-06-02', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1932134962', 0, 'N', 0, '2012-06-13', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000173', 'ABQ000173', 'NM01', 'ABQ Health Partners', 'Yelena', '', 'Kamoeva', 'CNP', 'Hospitalist', '', '', NULL, 'O', '500 Walter St NE Ste 309', 'Albuquerque', 'Bernalillo', 'NM', '87102', '5057278039', '5057278086', '500 Walter St NE Ste 309', 'Albuquerque', 'Bernalillo', 'NM', '87102', '5057278039', '5057278086', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2014-03-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1598044612', 0, 'N', 0, '2014-04-29', NULL, NULL, 35.0863, -106.64, NULL, NULL),
('204043287', 'ABQ000973', 'ABQ000973', 'NM01', 'ABQ Health Partners', 'Yelena', '', 'Kamoeva', 'CNP', 'Hospitalist', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5057278039', '5057278086', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5057278039', '5057278086', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2014-03-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1598044612', 0, 'N', 0, '2014-04-29', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000573', 'ABQ000573', 'NM01', 'ABQ Health Partners', 'Yelena', '', 'Kamoeva', 'CNP', 'Hospitalist', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5057278039', '5057278086', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5057278039', '5057278086', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2014-03-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1598044612', 0, 'N', 0, '2014-04-29', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000174', 'ABQ000174', 'NM01', 'ABQ Health Partners', 'Muhannad', '', 'Kanbour', 'MD', 'Hospitalist', '', '', NULL, 'O', '500 Walter St NE Ste 309', 'Albuquerque', 'Bernalillo', 'NM', '87102', '5057278039', '5057278086', '500 Walter St NE Ste 309', 'Albuquerque', 'Bernalillo', 'NM', '87102', '5057278039', '5057278086', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2013-02-15', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1053371575', 0, 'N', 0, '2013-02-22', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000974', 'ABQ000974', 'NM01', 'ABQ Health Partners', 'Muhannad', '', 'Kanbour', 'MD', 'Hospitalist', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5057278039', '5057278086', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5057278039', '5057278086', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2013-02-15', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1053371575', 0, 'N', 0, '2013-02-22', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000574', 'ABQ000574', 'NM01', 'ABQ Health Partners', 'Muhannad', '', 'Kanbour', 'MD', 'Hospitalist', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5057278039', '5057278086', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5057278039', '5057278086', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2013-02-15', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1053371575', 0, 'N', 0, '2013-02-22', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000175', 'ABQ000175', 'NM01', 'ABQ Health Partners', 'Pawitta', '', 'Kasemsap', 'MD', 'Pediatrics', '', '', NULL, 'O', '1721 Rio Rancho Blvd SE', 'Rio Rancho', 'Sandoval', 'NM', '87124', '5058968600', '5057273505', '1721 Rio Rancho Blvd SE', 'Rio Rancho', 'Sandoval', 'NM', '87124', '5058968600', '5057273505', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Medical Center', 'Lovelace Womens Hospital', 'Lovelace Westside Hospital ', NULL, 'HCFA|UB|', '1922031426', 0, 'N', 0, '2011-10-20', NULL, NULL, 35.2284, -106.66, NULL, NULL),
('204043287', 'ABQ000975', 'ABQ000975', 'NM01', 'ABQ Health Partners', 'Pawitta', '', 'Kasemsap', 'MD', 'Pediatrics', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5058968600', '5057273505', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5058968600', '5057273505', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Medical Center', 'Lovelace Womens Hospital', 'Lovelace Westside Hospital ', NULL, 'HCFA|UB|', '1922031426', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000575', 'ABQ000575', 'NM01', 'ABQ Health Partners', 'Pawitta', '', 'Kasemsap', 'MD', 'Pediatrics', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5058968600', '5057273505', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5058968600', '5057273505', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Medical Center', 'Lovelace Womens Hospital', 'Lovelace Westside Hospital ', NULL, 'HCFA|UB|', '1922031426', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000176', 'ABQ000176', 'NM01', 'ABQ Health Partners', 'Joseph', '', 'Kern', 'MD', 'Sleep Medicine', '', '', NULL, 'O', '4700 Jefferson St NE Ste 800', 'Albuquerque', 'Bernalillo', 'NM', '87109', '5058726000', '5058726003', '4700 Jefferson St NE Ste 800', 'Albuquerque', 'Bernalillo', 'NM', '87109', '5058726000', '5058726003', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1710989512', 0, 'N', 0, '2011-10-20', NULL, NULL, 35.1342, -106.593, NULL, NULL),
('204043287', 'ABQ000976', 'ABQ000976', 'NM01', 'ABQ Health Partners', 'Joseph', '', 'Kern', 'MD', 'Sleep Medicine', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5058726000', '5058726003', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5058726000', '5058726003', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1710989512', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000576', 'ABQ000576', 'NM01', 'ABQ Health Partners', 'Joseph', '', 'Kern', 'MD', 'Sleep Medicine', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5058726000', '5058726003', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5058726000', '5058726003', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1710989512', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000177', 'ABQ000177', 'NM01', 'ABQ Health Partners', 'Michelle', '', 'Khoo', 'MD', 'Cardiology', '', '', NULL, 'O', '500 Walter St NE Ste 401', 'Albuquerque', 'Bernalillo', 'NM', '87102', '5052627451', '5052627870', '500 Walter St NE Ste 401', 'Albuquerque', 'Bernalillo', 'NM', '87102', '5052627451', '5052627870', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Medical Center', 'Lovelace Womens Hospital', 'Lovelace Westside Hospital ', NULL, 'HCFA|UB|', '1245267236', 0, 'N', 0, '2012-07-03', NULL, NULL, 35.0863, -106.64, NULL, NULL),
('204043287', 'ABQ000977', 'ABQ000977', 'NM01', 'ABQ Health Partners', 'Michelle', '', 'Khoo', 'MD', 'Cardiology', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052627451', '5052627870', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052627451', '5052627870', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Medical Center', 'Lovelace Womens Hospital', 'Lovelace Westside Hospital ', NULL, 'HCFA|UB|', '1245267236', 0, 'N', 0, '2012-07-03', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000577', 'ABQ000577', 'NM01', 'ABQ Health Partners', 'Michelle', '', 'Khoo', 'MD', 'Cardiology', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052627451', '5052627870', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052627451', '5052627870', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Medical Center', 'Lovelace Womens Hospital', 'Lovelace Westside Hospital ', NULL, 'HCFA|UB|', '1245267236', 0, 'N', 0, '2012-07-03', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000178', 'ABQ000178', 'NM01', 'ABQ Health Partners', 'Catharine', '', 'Kincaid', 'MD', 'Hospitalist', '', '', NULL, 'O', '500 Walter St NE Ste 309', 'Albuquerque', 'Bernalillo', 'NM', '87102', '5057278039', '5057278086', '500 Walter St NE Ste 309', 'Albuquerque', 'Bernalillo', 'NM', '87102', '5057278039', '5057278086', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1508916784', 0, 'N', 0, '2011-10-20', NULL, NULL, 35.0863, -106.64, NULL, NULL),
('204043287', 'ABQ000978', 'ABQ000978', 'NM01', 'ABQ Health Partners', 'Catharine', '', 'Kincaid', 'MD', 'Hospitalist', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5057278039', '5057278086', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5057278039', '5057278086', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1508916784', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000578', 'ABQ000578', 'NM01', 'ABQ Health Partners', 'Catharine', '', 'Kincaid', 'MD', 'Hospitalist', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5057278039', '5057278086', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5057278039', '5057278086', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1508916784', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000179', 'ABQ000179', 'NM01', 'ABQ Health Partners', 'Patricia', '', 'Kingston', 'NP', 'Hand Surgery', 'Orthopedic Surgery', '', NULL, 'O', '101 Hospital Loop NE Ste 201', 'Albuquerque', 'Bernalillo', 'NM', '87109', '5052627375', '5052627776', '101 Hospital Loop NE Ste 201', 'Albuquerque', 'Bernalillo', 'NM', '87109', '5052627375', '5052627776', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2012-01-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1487790432', 0, 'N', 0, '2012-01-18', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000979', 'ABQ000979', 'NM01', 'ABQ Health Partners', 'Patricia', '', 'Kingston', 'NP', 'Hand Surgery', 'Orthopedic Surgery', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052627375', '5052627776', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052627375', '5052627776', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2012-01-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1487790432', 0, 'N', 0, '2012-01-18', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000579', 'ABQ000579', 'NM01', 'ABQ Health Partners', 'Patricia', '', 'Kingston', 'NP', 'Hand Surgery', 'Orthopedic Surgery', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052627375', '5052627776', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052627375', '5052627776', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2012-01-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1487790432', 0, 'N', 0, '2012-01-18', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000183', 'ABQ000183', 'NM01', 'ABQ Health Partners', 'Brooke', '', 'Kivitz', 'PA-C', 'Urgent Care', '', '', NULL, 'O', '200 Rio Bravo Blvd SE', 'Albuquerque', 'Bernalillo', 'NM', '87105', '5058736401', '5058736408', '200 Rio Bravo Blvd SE', 'Albuquerque', 'Bernalillo', 'NM', '87105', '5058736401', '5058736408', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2012-01-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1417100868', 0, 'Y', 0, '2013-09-30', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000980', 'ABQ000980', 'NM01', 'ABQ Health Partners', 'Brooke', '', 'Kivitz', 'PA-C', 'Urgent Care', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5058968604', '5058968697', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5058968604', '5058968697', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2012-08-20', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1417100868', 0, 'Y', 0, '2013-09-30', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000580', 'ABQ000580', 'NM01', 'ABQ Health Partners', 'Brooke', '', 'Kivitz', 'PA-C', 'Urgent Care', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5058968604', '5058968697', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5058968604', '5058968697', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2012-08-20', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1417100868', 0, 'N', 0, '2013-09-30', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000184', 'ABQ000184', 'NM01', 'ABQ Health Partners', 'Ben', '', 'Klein', 'PhD', 'Pain Management', '', '', NULL, 'O', '5310 Homestead Rd NE Ste 201', 'Albuquerque', 'Bernalillo', 'NM', '87110', '5052627724', '5052623476', '5310 Homestead Rd NE Ste 201', 'Albuquerque', 'Bernalillo', 'NM', '87110', '5052627724', '5052623476', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2012-01-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1649203134', 0, 'N', 0, '2012-11-12', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000984', 'ABQ000984', 'NM01', 'ABQ Health Partners', 'Ben', '', 'Klein', 'PhD', 'Pain Management', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052627724', '5052623476', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052627724', '5052623476', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2012-10-12', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1649203134', 0, 'N', 0, '2012-11-12', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000584', 'ABQ000584', 'NM01', 'ABQ Health Partners', 'Ben', '', 'Klein', 'PhD', 'Pain Management', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052627724', '5052623476', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052627724', '5052623476', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2012-10-12', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1649203134', 0, 'N', 0, '2012-11-12', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000185', 'ABQ000185', 'NM01', 'ABQ Health Partners', 'Peter', '', 'Koenigsberg', 'MD', 'Family Practice', '', '', NULL, 'O', '200 Rio Bravo Blvd SE', 'Albuquerque', 'Bernalillo', 'NM', '87105', '5058736400', '5058736403', '200 Rio Bravo Blvd SE', 'Albuquerque', 'Bernalillo', 'NM', '87105', '5058736400', '5058736403', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1366475865', 0, 'N', 0, '2011-10-20', NULL, NULL, 35.027, -106.655, NULL, NULL),
('204043287', 'ABQ000985', 'ABQ000985', 'NM01', 'ABQ Health Partners', 'Peter', '', 'Koenigsberg', 'MD', 'Family Practice', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5058736400', '5058736403', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5058736400', '5058736403', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1366475865', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000585', 'ABQ000585', 'NM01', 'ABQ Health Partners', 'Peter', '', 'Koenigsberg', 'MD', 'Family Practice', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5058736400', '5058736403', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5058736400', '5058736403', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1366475865', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000186', 'ABQ000186', 'NM01', 'ABQ Health Partners', 'Hope', '', 'Korin', 'MD', 'Pathology', '', '', NULL, 'O', '4701 Montgomery Blvd NE Ste 201', 'Albuquerque', 'Bernalillo', 'NM', '87109', '5057276733', '5057276130', '4701 Montgomery Blvd NE Ste 201', 'Albuquerque', 'Bernalillo', 'NM', '87109', '5057276733', '5057276130', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2014-02-09', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1972536548', 0, 'N', 0, '2014-02-05', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000986', 'ABQ000986', 'NM01', 'ABQ Health Partners', 'Hope', '', 'Korin', 'MD', 'Pathology', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5057276733', '5057276130', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5057276733', '5057276130', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2014-02-09', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1972536548', 0, 'N', 0, '2014-02-05', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000586', 'ABQ000586', 'NM01', 'ABQ Health Partners', 'Hope', '', 'Korin', 'MD', 'Pathology', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5057276733', '5057276130', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5057276733', '5057276130', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2014-02-09', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1972536548', 0, 'N', 0, '2014-02-05', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000187', 'ABQ000187', 'NM01', 'ABQ Health Partners', 'Douglas', '', 'Krell', 'MD', 'Obstetrics and Gynecology', '', '', NULL, 'O', '10511 Golf Course Rd NW Ste 204', 'Albuquerque', 'Bernalillo', 'NM', '87114', '5052546500', '5052546532', '10511 Golf Course Rd NW Ste 204', 'Albuquerque', 'Bernalillo', 'NM', '87114', '5052546500', '5052546532', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2013-10-02', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1043245061', 0, 'N', 0, '2013-10-21', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000987', 'ABQ000987', 'NM01', 'ABQ Health Partners', 'Douglas', '', 'Krell', 'MD', 'Obstetrics and Gynecology', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052546500', '5052546532', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052546500', '5052546532', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2013-10-02', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1043245061', 0, 'N', 0, '2013-10-21', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000587', 'ABQ000587', 'NM01', 'ABQ Health Partners', 'Douglas', '', 'Krell', 'MD', 'Obstetrics and Gynecology', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052546500', '5052546532', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052546500', '5052546532', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2013-10-02', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1043245061', 0, 'N', 0, '2013-10-21', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000189', 'ABQ000189', 'NM01', 'ABQ Health Partners', 'Vijayalakshmi', '', 'Kumar', 'MD', 'Rheumatology', '', '', NULL, 'O', '5150 Journal Ctr Blvd NE', 'Albuquerque', 'Bernalillo', 'NM', '87109', '5052627248', '5052623190', '5150 Journal Center Blvd NE', 'Albuquerque', 'Bernalillo', 'NM', '87109', '5052627248', '5052623190', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Medical Center', 'Lovelace Womens Hospital', NULL, NULL, 'HCFA|UB|', '1881627453', 0, 'N', 0, '2011-10-20', NULL, NULL, 35.1702, -106.586, NULL, NULL);
INSERT INTO `providers_new` (`Provider_Tax_ID`, `Provider_Suffix`, `Provider_Network_ID`, `Provider_Region`, `Provider_Name`, `Provider_Doctor_First_Name`, `Provider_Doctor_Middle_Name`, `Provider_Doctor_Last_Name`, `Provider_Doctor_Degree`, `Provider_Specialty_1`, `Provider_Specialty_2`, `Provider_Specialty_3`, `Provider_Specialty_4`, `Provider_Address_Type`, `Provider_Address`, `Provider_City`, `Provider_County`, `Provider_State`, `Provider_Zip`, `Provider_Phone`, `Provider_Fax`, `Provider_Mailing_Address`, `Provider_Mailing_City`, `Provider_Mailing_County`, `Provider_Mailing_State`, `Provider_Mailing_Zip`, `Provider_Mailing_Phone`, `Provider_Mailing_Fax`, `Provider_Primary_Schedule`, `Provider_Secondary_Schedule`, `Provider_Rate_Sheet`, `Provider_Anes_Rate`, `Provider_Default_Rate`, `Provider_Max_DOS`, `Provider_Min_Match_Value`, `Provider_Effective_Date`, `Provider_Term_Date`, `Provider_Pend`, `Provider_Anes_Minutes`, `Provider_PPO`, `Provider_Hospital_1`, `Provider_Hospital_2`, `Provider_Hospital_3`, `Provider_Hospital_4`, `Provider_Type`, `Provider_NPI`, `Provider_Check_Override`, `Exclude_Dir`, `Audit_Status`, `Last_Change_Date`, `Medicare_ID`, `Provider_Lang`, `Provider_Latitude`, `Provider_Longitude`, `Provider_school`, `Provider_cert`) VALUES
('204043287', 'ABQ000588', 'ABQ000588', 'NM01', 'ABQ Health Partners', 'Vijayalakshmi', '', 'Kumar', 'MD', 'Rheumatology', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052627248', '5052623190', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052627248', '5052623190', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Medical Center', 'Lovelace Womens Hospital', NULL, NULL, 'HCFA|UB|', '1881627453', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000990', 'ABQ000990', 'NM01', 'ABQ Health Partners', 'Rachel', '', 'Landavazo', 'PA-C', 'General Surgery', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052627281', '5052627622', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052627281', '5052627622', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2013-05-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1558376012', 0, 'N', 0, '2013-05-31', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000190', 'ABQ000190', 'NM01', 'ABQ Health Partners', 'Rachel', '', 'Landavazo', 'PA-C', 'General Surgery', '', '', NULL, 'O', '715 Dr Martin Luther King Jr Ave NE Ste 301', 'Albuquerque', 'Bernalillo', 'NM', '87102', '5052627281', '5052627622', '715 Dr Martin Luther King Jr Ave NE Ste 301', 'Albuquerque', 'Bernalillo', 'NM', '87102', '5052627281', '5052627622', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2013-05-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1558376012', 0, 'N', 0, '2013-05-31', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000590', 'ABQ000590', 'NM01', 'ABQ Health Partners', 'Rachel', '', 'Landavazo', 'PA-C', 'General Surgery', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052627281', '5052627622', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052627281', '5052627622', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2013-05-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1558376012', 0, 'N', 0, '2013-05-31', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000191', 'ABQ000191', 'NM01', 'ABQ Health Partners', 'Kenna', '', 'Larsen', 'MD', 'Hand Surgery', 'Orthopedic Surgery', '', NULL, 'O', '101 Hospital Loop NE Ste 201', 'Albuquerque', 'Bernalillo', 'NM', '87109', '5052627375', '5052627776', '101 Hospital Loop NE Ste 201', 'Albuquerque', 'Bernalillo', 'NM', '87109', '5052627375', '5052627776', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2013-10-01', 0, 0, 0, 'Lovelace Medical Center', '', '', '', 'HCFA|UB|', '1073723375', 0, 'N', 0, '2014-07-14', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000991', 'ABQ000991', 'NM01', 'ABQ Health Partners', 'Kenna', '', 'Larsen', 'MD', 'Hand Surgery', 'Orthopedic Surgery', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052627375', '5052627776', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052627375', '5052627776', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2014-07-01', 0, 0, 0, 'Lovelace Medical Center', '', '', '', 'HCFA|UB|', '1073723375', 0, 'N', 0, '2014-07-14', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000591', 'ABQ000591', 'NM01', 'ABQ Health Partners', 'Kenna', '', 'Larsen', 'MD', 'Hand Surgery', 'Orthopedic Surgery', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052627375', '5052627776', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052627375', '5052627776', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2014-07-01', 0, 0, 0, 'Lovelace Medical Center', '', '', '', 'HCFA|UB|', '1073723375', 0, 'N', 0, '2014-07-14', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000340', 'ABQ000340', 'NM01', 'ABQ Health Partners', 'Donna', '', 'Tomky', 'NP', 'Endocrinology', '', '', NULL, 'O', '5400 Gibson Blvd SE', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052627455', '5052623955', '5400 Gibson Blvd SE', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052627455', '5052623955', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1952334526', 0, 'N', 0, '2011-10-20', NULL, NULL, 35.0583, -106.582, NULL, NULL),
('204043287', 'ABQ000740', 'ABQ000740', 'NM01', 'ABQ Health Partners', 'Donna', '', 'Tomky', 'NP', 'Endocrinology', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052627455', '5052623955', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052627455', '5052623955', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1952334526', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000193', 'ABQ000193', 'NM01', 'ABQ Health Partners', 'Laurence', '', 'Laudicina', 'MD', 'Orthopedic Surgery', '', '', NULL, 'O', '5150 Journal Ctr Blvd NE', 'Albuquerque', 'Bernalillo', 'NM', '87109', '5053428400', '5053428401', '5150 Journal Center Blvd NE', 'Albuquerque', 'Bernalillo', 'NM', '87109', '5053428400', '5053428401', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Womens Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1134108186', 0, 'N', 0, '2011-10-20', NULL, NULL, 35.1702, -106.586, NULL, NULL),
('204043287', 'ABQ000992', 'ABQ000992', 'NM01', 'ABQ Health Partners', 'Laurence', '', 'Laudicina', 'MD', 'Orthopedic Surgery', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5053428400', '5053428401', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5053428400', '5053428401', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Womens Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1134108186', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000592', 'ABQ000592', 'NM01', 'ABQ Health Partners', 'Laurence', '', 'Laudicina', 'MD', 'Orthopedic Surgery', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5053428400', '5053428401', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5053428400', '5053428401', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Womens Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1134108186', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000194', 'ABQ000194', 'NM01', 'ABQ Health Partners', 'Seth', '', 'Launer', 'DPM', 'Podiatry', '', '', NULL, 'O', '10511 Golf Course Rd NW Ste 103', 'Albuquerque', 'Bernalillo', 'NM', '87114', '5052321140', '5052321141', '10511 Golf Course Rd NW Ste 103', 'Albuquerque', 'Bernalillo', 'NM', '87114', '5052321140', '5052321141', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1184659112', 0, 'N', 0, '2011-10-20', NULL, NULL, 35.2073, -106.676, NULL, NULL),
('204043287', 'ABQ000994', 'ABQ000994', 'NM01', 'ABQ Health Partners', 'Seth', '', 'Launer', 'DPM', 'Podiatry', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052321140', '5052321141', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052321140', '5052321141', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1184659112', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000594', 'ABQ000594', 'NM01', 'ABQ Health Partners', 'Seth', '', 'Launer', 'DPM', 'Podiatry', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052321140', '5052321141', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052321140', '5052321141', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1184659112', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000195', 'ABQ000195', 'NM01', 'ABQ Health Partners', 'Rita', '', 'Leard', 'MD', 'Obstetrics and Gynecology', '', '', NULL, 'O', '4705 Montgomery Blvd NE Ste 301-302', 'Albuquerque', 'Bernalillo', 'NM', '87109', '5052546500', '5052546532', '4705 Montgomery Blvd NE Ste 301-302', 'Albuquerque', 'Bernalillo', 'NM', '87109', '5052546500', '5052546532', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2013-09-03', 0, 0, 0, 'Lovelace Womens Hospital', 'Lovelace Westside Hospital', NULL, NULL, 'HCFA|UB|', '1972634665', 0, 'N', 0, '2013-09-09', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000995', 'ABQ000995', 'NM01', 'ABQ Health Partners', 'Rita', '', 'Leard', 'MD', 'Obstetrics and Gynecology', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052546500', '5052546532', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052546500', '5052546532', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Womens Hospital', 'Lovelace Westside Hospital', NULL, NULL, 'HCFA|UB|', '1972634665', 0, 'N', 0, '2013-09-09', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000595', 'ABQ000595', 'NM01', 'ABQ Health Partners', 'Rita', '', 'Leard', 'MD', 'Obstetrics and Gynecology', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052546500', '5052546532', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052546500', '5052546532', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Womens Hospital', 'Lovelace Westside Hospital', NULL, NULL, 'HCFA|UB|', '1972634665', 0, 'N', 0, '2013-09-09', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000196', 'ABQ000196', 'NM01', 'ABQ Health Partners', 'James', '', 'Leitera', 'CNP', 'Cardiovascular Disease', '', '', NULL, 'O', '500 Walter St NE Ste 401', 'Albuquerque', 'Bernalillo', 'NM', '87102', '5052627451', '5052627870', '500 Walter St NE Ste 401', 'Albuquerque', 'Bernalillo', 'NM', '87102', '5052627451', '5052627870', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2012-05-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1386939452', 0, 'N', 0, '2012-06-13', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000996', 'ABQ000996', 'NM01', 'ABQ Health Partners', 'James', '', 'Leitera', 'CNP', 'Cardiovascular Disease', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052627451', '5052627870', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052627451', '5052627870', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2012-05-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1386939452', 0, 'N', 0, '2012-06-13', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000596', 'ABQ000596', 'NM01', 'ABQ Health Partners', 'James', '', 'Leitera', 'CNP', 'Cardiovascular Disease', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052627451', '5052627870', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052627451', '5052627870', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2012-05-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1386939452', 0, 'N', 0, '2012-06-13', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000197', 'ABQ000197', 'NM01', 'ABQ Health Partners', 'Michael', '', 'Lentz', 'PA-C', 'Pediatrics', '', '', NULL, 'O', '5400 Gibson Blvd SE', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052627594', '5052627641', '5400 Gibson Blvd SE', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052627594', '5052627641', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Womens Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1770597510', 0, 'N', 0, '2011-10-20', NULL, NULL, 35.0583, -106.582, NULL, NULL),
('204043287', 'ABQ000597', 'ABQ000597', 'NM01', 'ABQ Health Partners', 'Michael', '', 'Lentz', 'PA-C', 'Pediatrics', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052627594', '5052627641', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052627594', '5052627641', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Womens Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1770597510', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000201', 'ABQ000201', 'NM01', 'ABQ Health Partners', 'John', '', 'Link', 'MD', 'Urgent Care', '', '', NULL, 'O', '1721 Rio Rancho Blvd SE', 'Rio Rancho', 'Sandoval', 'NM', '87124', '5058968604', '5058968697', '1721 Rio Rancho Blvd SE', 'Rio Rancho', 'Sandoval', 'NM', '87124', '5058968604', '5058968697', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2014-04-11', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1780623801', 0, 'Y', 0, '2014-04-29', NULL, NULL, 35.2284, -106.66, NULL, NULL),
('204043287', 'ABQ000998', 'ABQ000998', 'NM01', 'ABQ Health Partners', 'John', '', 'Link', 'MD', 'Urgent Care', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5058968604', '5058968697', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5058968604', '5058968697', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2014-04-11', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1780623801', 0, 'N', 0, '2014-04-29', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000598', 'ABQ000598', 'NM01', 'ABQ Health Partners', 'John', '', 'Link', 'MD', 'Urgent Care', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5058968604', '5058968697', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5058968604', '5058968697', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2014-04-11', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1780623801', 0, 'N', 0, '2014-04-29', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ001002', 'ABQ001002', 'NM01', 'ABQ Health Partners', 'Xiaolong', '', 'Liu', 'MD', 'Pathology', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5057276450', '5057278391', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5057276450', '5057278391', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1992782403', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000202', 'ABQ000202', 'NM01', 'ABQ Health Partners', 'Xiaolong', '', 'Liu', 'MD', 'Pathology', '', '', NULL, 'O', '601 Dr Martin Luther King Jr Ave NE', 'Albuquerque', 'Bernalillo', 'NM', '87102', '5057276450', '5057278391', '601 Dr Martin Luther King Jr Ave NE', 'Albuquerque', 'Bernalillo', 'NM', '87102', '5057276450', '5057278391', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1992782403', 0, 'N', 0, '2011-10-20', NULL, NULL, 35.0857, -106.64, NULL, NULL),
('204043287', 'ABQ000602', 'ABQ000602', 'NM01', 'ABQ Health Partners', 'Xiaolong', '', 'Liu', 'MD', 'Pathology', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5057276450', '5057278391', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5057276450', '5057278391', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1992782403', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000203', 'ABQ000203', 'NM01', 'ABQ Health Partners', 'Jerald', '', 'Loy', 'PA-C', 'Family Practice', '', '', NULL, 'O', '3901 Carlisle Blvd NE', 'Albuquerque', 'Bernalillo', 'NM', '87107', '5058888500', '5058888503', '3901 Carlisle Blvd NE', 'Albuquerque', 'Bernalillo', 'NM', '87107', '5058888500', '5058888503', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1104851021', 0, 'N', 0, '2011-10-20', NULL, NULL, 35.1252, -106.604, NULL, NULL),
('204043287', 'ABQ001003', 'ABQ001003', 'NM01', 'ABQ Health Partners', 'Jerald', '', 'Loy', 'PA-C', 'Family Practice', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5058888500', '5058888503', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5058888500', '5058888503', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1104851021', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000603', 'ABQ000603', 'NM01', 'ABQ Health Partners', 'Jerald', '', 'Loy', 'PA-C', 'Family Practice', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5058888500', '5058888503', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5058888500', '5058888503', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1104851021', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000204', 'ABQ000204', 'NM01', 'ABQ Health Partners', 'Dennis', '', 'Lucero', 'MD', 'Hospitalist', '', '', NULL, 'O', '500 Walter St NE Ste 401', 'Albuquerque', 'Bernalillo', 'NM', '87102', '5057278039', '5057278086', '500 Walter St NE Ste 401', 'Albuquerque', 'Bernalillo', 'NM', '87102', '5057278039', '5057278086', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1386667491', 0, 'N', 0, '2014-06-13', NULL, NULL, 35.0863, -106.64, NULL, NULL),
('204043287', 'ABQ001004', 'ABQ001004', 'NM01', 'ABQ Health Partners', 'Dennis', '', 'Lucero', 'MD', 'Hospitalist', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5057278039', '5057278086', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5057278039', '5057278086', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1386667491', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000604', 'ABQ000604', 'NM01', 'ABQ Health Partners', 'Dennis', '', 'Lucero', 'MD', 'Hospitalist', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5057278039', '5057278086', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5057278039', '5057278086', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1386667491', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000208', 'ABQ000208', 'NM01', 'ABQ Health Partners', 'Bruce', '', 'Lundblad', 'DO', 'Urgent Care', '', '', NULL, 'O', '1721 Rio Rancho Blvd SE', 'Rio Rancho', 'Sandoval', 'NM', '87124', '5058968604', '5058968697', '1721 Rio Rancho Blvd SE', 'Rio Rancho', 'Sandoval', 'NM', '87124', '5058968604', '5058968697', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2012-10-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1619902731', 0, 'Y', 0, '2012-11-21', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ001005', 'ABQ001005', 'NM01', 'ABQ Health Partners', 'Bruce', '', 'Lundblad', 'DO', 'Urgent Care', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5058968604', '5058968697', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5058968604', '5058968697', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2012-10-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1619902731', 0, 'N', 0, '2012-11-21', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000605', 'ABQ000605', 'NM01', 'ABQ Health Partners', 'Bruce', '', 'Lundblad', 'DO', 'Urgent Care', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5058968604', '5058968697', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5058968604', '5058968697', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2012-10-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1619902731', 0, 'N', 0, '2012-11-21', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000209', 'ABQ000209', 'NM01', 'ABQ Health Partners', 'Carlos', '', 'Macias', 'MD', 'Hospitalist', '', '', NULL, 'O', '500 Walter St NE Ste 309', 'Albuquerque', 'Bernalillo', 'NM', '87102', '5057278039', '5057278086', '500 Walter St NE Ste 309', 'Albuquerque', 'Bernalillo', 'NM', '87102', '5057278039', '5057278086', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2012-01-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1104965193', 0, 'N', 0, '2012-01-17', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ001009', 'ABQ001009', 'NM01', 'ABQ Health Partners', 'Carlos', '', 'Macias', 'MD', 'Hospitalist', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5057278039', '5057278086', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5057278039', '5057278086', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2012-01-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1104965193', 0, 'N', 0, '2012-01-17', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000609', 'ABQ000609', 'NM01', 'ABQ Health Partners', 'Carlos', '', 'Macias', 'MD', 'Hospitalist', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5057278039', '5057278086', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5057278039', '5057278086', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2012-01-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1104965193', 0, 'N', 0, '2012-01-17', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000210', 'ABQ000210', 'NM01', 'ABQ Health Partners', 'Laurie', '', 'MacLeod', 'CNM', 'Obstetrics and Gynecology', '', '', NULL, 'O', '5150 Journal Ctr Blvd NE', 'Albuquerque', 'Bernalillo', 'NM', '87109', '5052546500', '5052623198', '5150 Journal Ctr Blvd NE', 'Albuquerque', 'Bernalillo', 'NM', '87109', '5052546500', '5052623198', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2013-07-29', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1639279565', 0, 'N', 0, '2013-08-15', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ001010', 'ABQ001010', 'NM01', 'ABQ Health Partners', 'Laurie', '', 'MacLeod', 'CNM', 'Obstetrics and Gynecology', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052546500', '5052623198', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052546500', '5052623198', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2013-07-29', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1639279565', 0, 'N', 0, '2013-08-15', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000610', 'ABQ000610', 'NM01', 'ABQ Health Partners', 'Laurie', '', 'MacLeod', 'CNM', 'Obstetrics and Gynecology', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052546500', '5052623198', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052546500', '5052623198', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2013-07-29', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1639279565', 0, 'N', 0, '2013-08-15', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000211', 'ABQ000211', 'NM01', 'ABQ Health Partners', 'Amelia', '', 'Maestas', 'CNM', 'Obstetrics and Gynecology', '', '', NULL, 'O', '10511 Golf Course Rd NW Ste 204', 'Albuquerque', 'Bernalillo', 'NM', '87114', '5052546500', '5052546532', '10511 Golf Course Rd NW Ste 204', 'Albuquerque', 'Bernalillo', 'NM', '87114', '5052546500', '5052546532', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Womens Hospital', '', '', '', 'HCFA|UB|', '1487687075', 0, 'N', 0, '2014-06-24', NULL, NULL, 35.2073, -106.676, NULL, NULL),
('204043287', 'ABQ001011', 'ABQ001011', 'NM01', 'ABQ Health Partners', 'Amelia', '', 'Maestas', 'CNM', 'Obstetrics and Gynecology', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052546500', '5052546532', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052546500', '5052546532', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Womens Hospital', '', '', '', 'HCFA|UB|', '1487687075', 0, 'N', 0, '2014-06-24', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000611', 'ABQ000611', 'NM01', 'ABQ Health Partners', 'Amelia', '', 'Maestas', 'CNM', 'Obstetrics and Gynecology', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052546500', '5052546532', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052546500', '5052546532', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Womens Hospital', '', '', '', 'HCFA|UB|', '1487687075', 0, 'N', 0, '2014-06-24', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000212', 'ABQ000212', 'NM01', 'ABQ Health Partners', 'Michael', '', 'Malizzo', 'MD', 'Pain Management', '', '', NULL, 'O', '5310 Homestead Rd NE Ste 201', 'Albuquerque', 'Bernalillo', 'NM', '87110', '5052627724', '5052623476', '5310 Homestead Rd NE Ste 201', 'Albuquerque', 'Bernalillo', 'NM', '87110', '5052627724', '5052623476', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1538182647', 0, 'N', 0, '2011-10-20', NULL, NULL, 35.1289, -106.584, NULL, NULL),
('204043287', 'ABQ001012', 'ABQ001012', 'NM01', 'ABQ Health Partners', 'Michael', '', 'Malizzo', 'MD', 'Pain Management', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052627724', '5052623476', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052627724', '5052623476', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1538182647', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000612', 'ABQ000612', 'NM01', 'ABQ Health Partners', 'Michael', '', 'Malizzo', 'MD', 'Pain Management', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052627724', '5052623476', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052627724', '5052623476', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1538182647', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000213', 'ABQ000213', 'NM01', 'ABQ Health Partners', 'Alice', '', 'Marosi', 'MD', 'Pediatrics', '', '', NULL, 'O', '5400 Gibson Blvd SE', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052627594', '5052627641', '5400 Gibson Blvd SE', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052627594', '5052627641', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2012-01-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1417982349', 0, 'N', 0, '2012-02-16', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000613', 'ABQ000613', 'NM01', 'ABQ Health Partners', 'Alice', '', 'Marosi', 'MD', 'Pediatrics', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052627594', '5052627641', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052627594', '5052627641', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2012-01-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1417982349', 0, 'N', 0, '2012-02-16', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000214', 'ABQ000214', 'NM01', 'ABQ Health Partners', 'Teresa', '', 'Marroquin-Elizondo', 'CDE', 'Diabetic Education', '', '', NULL, 'O', '5400 Gibson Blvd SE', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052627455', '5052623955', '5400 Gibson Blvd SE', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052627455', '5052623955', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1457384018', 0, 'N', 0, '2013-09-09', NULL, NULL, 35.0583, -106.582, NULL, NULL),
('204043287', 'ABQ000614', 'ABQ000614', 'NM01', 'ABQ Health Partners', 'Teresa', '', 'Marroquin-Elizondo', 'CDE', 'Diabetic Education', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052627455', '5052623955', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052627455', '5052623955', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1457384018', 0, 'N', 0, '2013-09-09', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000215', 'ABQ000215', 'NM01', 'ABQ Health Partners', 'Joanne', '', 'Marsh', 'CNP', 'Family Practice', '', '', NULL, 'O', '3901 Carlisle Blvd NE', 'Albuquerque', 'Bernalillo', 'NM', '87107', '5058888500', '5058888503', '3901 Carlisle Blvd NE', 'Albuquerque', 'Bernalillo', 'NM', '87107', '5058888500', '5058888503', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2012-05-02', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1285636712', 0, 'N', 0, '2012-05-02', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ001015', 'ABQ001015', 'NM01', 'ABQ Health Partners', 'Joanne', '', 'Marsh', 'CNP', 'Family Practice', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5058888500', '5058888503', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5058888500', '5058888503', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2012-05-02', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1285636712', 0, 'N', 0, '2012-05-02', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000615', 'ABQ000615', 'NM01', 'ABQ Health Partners', 'Joanne', '', 'Marsh', 'CNP', 'Family Practice', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5058888500', '5058888503', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5058888500', '5058888503', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2012-05-02', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1285636712', 0, 'N', 0, '2012-05-02', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000216', 'ABQ000216', 'NM01', 'ABQ Health Partners', 'Brooke', '', 'Martin', 'PA-C', 'Urgent Care', '', '', NULL, 'O', '1721 Rio Rancho Blvd SE', 'Rio Rancho', 'Sandoval', 'NM', '87124', '5058968600', '5058968618', '1721 Rio Rancho Blvd SE', 'Rio Rancho', 'Sandoval', 'NM', '87124', '5058968600', '5058968618', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1902831985', 0, 'Y', 0, '2013-01-25', NULL, NULL, 35.2284, -106.66, NULL, NULL),
('204043287', 'ABQ001016', 'ABQ001016', 'NM01', 'ABQ Health Partners', 'Brooke', '', 'Martin', 'PA-C', 'Urgent Care', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5058968600', '5058968618', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5058968600', '5058968618', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1902831985', 0, 'N', 0, '2013-01-25', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000616', 'ABQ000616', 'NM01', 'ABQ Health Partners', 'Brooke', '', 'Martin', 'PA-C', 'Urgent Care', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5058968600', '5058968618', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5058968600', '5058968618', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1902831985', 0, 'N', 0, '2013-01-25', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000218', 'ABQ000218', 'NM01', 'ABQ Health Partners', 'Michael', '', 'Martinez', 'MD', 'Urology', '', '', NULL, 'O', '10511 Golf Course Rd NW Ste 201', 'Albuquerque', 'Bernalillo', 'NM', '87114', '5052321180', '5052321181', '10511 Golf Course Rd NW Ste 201', 'Albuquerque', 'Bernalillo', 'NM', '87114', '5052321180', '5052321181', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Westside Hospital', 'Lovelace Womens Hospital', NULL, NULL, 'HCFA|UB|', '1669407771', 0, 'N', 0, '2011-10-20', NULL, NULL, 35.2073, -106.676, NULL, NULL),
('204043287', 'ABQ001017', 'ABQ001017', 'NM01', 'ABQ Health Partners', 'Michael', '', 'Martinez', 'MD', 'Urology', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052627275', '5052623366', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052627275', '5052623366', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Westside Hospital', 'Lovelace Womens Hospital', NULL, NULL, 'HCFA|UB|', '1669407771', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000617', 'ABQ000617', 'NM01', 'ABQ Health Partners', 'Michael', '', 'Martinez', 'MD', 'Urology', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052627275', '5052623366', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052627275', '5052623366', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Westside Hospital', 'Lovelace Womens Hospital', NULL, NULL, 'HCFA|UB|', '1669407771', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000219', 'ABQ000219', 'NM01', 'ABQ Health Partners', 'Robert', '', 'Martz', 'MD', 'Pediatrics', '', '', NULL, 'O', '5400 Gibson Blvd SE', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052627594', '5052627641', '5400 Gibson Blvd SE', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052627594', '5052627641', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Womens Hospital', 'Lovelace Westside Hospital', NULL, NULL, 'HCFA|UB|', '1780609446', 0, 'N', 0, '2011-10-20', NULL, NULL, 35.0583, -106.582, NULL, NULL),
('204043287', 'ABQ000619', 'ABQ000619', 'NM01', 'ABQ Health Partners', 'Robert', '', 'Martz', 'MD', 'Pediatrics', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052627594', '5052627641', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052627594', '5052627641', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Womens Hospital', 'Lovelace Westside Hospital', NULL, NULL, 'HCFA|UB|', '1780609446', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000220', 'ABQ000220', 'NM01', 'ABQ Health Partners', 'H. Preston', '', 'Matthews', 'DO', 'Family Practice', '', '', NULL, 'O', '1901 Juan Tabo Blvd NE', 'Albuquerque', 'Bernalillo', 'NM', '87112', '5052629200', '5052629201', '1901 Juan Tabo Blvd NE', 'Albuquerque', 'Bernalillo', 'NM', '87112', '5052629200', '5052629201', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1174546295', 0, 'N', 0, '2011-10-20', NULL, NULL, 35.1032, -106.516, NULL, NULL),
('204043287', 'ABQ001020', 'ABQ001020', 'NM01', 'ABQ Health Partners', 'H. Preston', '', 'Matthews', 'DO', 'Family Practice', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052629200', '5052629201', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052629200', '5052629201', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1174546295', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000620', 'ABQ000620', 'NM01', 'ABQ Health Partners', 'H. Preston', '', 'Matthews', 'DO', 'Family Practice', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052629200', '5052629201', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052629200', '5052629201', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1174546295', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000221', 'ABQ000221', 'NM01', 'ABQ Health Partners', 'Isam', '', 'Mawas', 'MD', 'Hospitalist', '', '', NULL, 'O', '500 Walter St NE Ste 309', 'Albuquerque', 'Bernalillo', 'NM', '87102', '5057278039', '5057278086', '500 Walter St NE Ste 309', 'Albuquerque', 'Bernalillo', 'NM', '87102', '5057278039', '5057278086', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2012-05-03', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1790971422', 0, 'N', 0, '2012-05-25', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ001021', 'ABQ001021', 'NM01', 'ABQ Health Partners', 'Isam', '', 'Mawas', 'MD', 'Hospitalist', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5057278039', '5057278086', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5057278039', '5057278086', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2012-05-03', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1790971422', 0, 'N', 0, '2012-05-25', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000621', 'ABQ000621', 'NM01', 'ABQ Health Partners', 'Isam', '', 'Mawas', 'MD', 'Hospitalist', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5057278039', '5057278086', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5057278039', '5057278086', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2012-05-03', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1790971422', 0, 'N', 0, '2012-05-25', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000222', 'ABQ000222', 'NM01', 'ABQ Health Partners', 'Annette', '', 'Maxedon', 'CNP', 'Family Practice', '', '', NULL, 'O', '1721 Rio Rancho Blvd SE', 'Rio Rancho', 'Sandoval', 'NM', '87124', '5058968600', '5058968618', '1721 Rio Rancho Blvd SE', 'Rio Rancho', 'Sandoval', 'NM', '87124', '5058968600', '5058968618', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1306967930', 0, 'N', 0, '2012-05-25', NULL, NULL, 35.2284, -106.66, NULL, NULL),
('204043287', 'ABQ001022', 'ABQ001022', 'NM01', 'ABQ Health Partners', 'Annette', '', 'Maxedon', 'CNP', 'Family Practice', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5058968600', '5058968618', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5058968600', '5058968618', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1306967930', 0, 'N', 0, '2012-05-25', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000622', 'ABQ000622', 'NM01', 'ABQ Health Partners', 'Annette', '', 'Maxedon', 'CNP', 'Family Practice', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5058968600', '5058968618', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5058968600', '5058968618', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1306967930', 0, 'N', 0, '2012-05-25', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000223', 'ABQ000223', 'NM01', 'ABQ Health Partners', 'Kathie', '', 'Maxwell', 'CNM', 'Obstetrics and Gynecology', '', '', NULL, 'O', '4705 Montgomery Blvd NE Ste 301-302', 'Albuquerque', 'Bernalillo', 'NM', '87109', '5052546500', '5052546532', '4705 Montgomery Blvd NE Ste 301-302', 'Albuquerque', 'Bernalillo', 'NM', '87109', '5052546500', '5052546532', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2013-09-03', 0, 0, 0, 'Lovelace Womens Hospital', 'Lovelace Westside Hospital', '', '', 'HCFA|UB|', '1609897388', 0, 'N', 0, '2014-06-24', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ001023', 'ABQ001023', 'NM01', 'ABQ Health Partners', 'Kathie', '', 'Maxwell', 'CNM', 'Obstetrics and Gynecology', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052546500', '5052546532', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052546500', '5052546532', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Womens Hospital', 'Lovelace Westside Hospital', '', '', 'HCFA|UB|', '1609897388', 0, 'N', 0, '2014-06-24', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000623', 'ABQ000623', 'NM01', 'ABQ Health Partners', 'Kathie', '', 'Maxwell', 'CNM', 'Obstetrics and Gynecology', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052546500', '5052546532', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052546500', '5052546532', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Womens Hospital', 'Lovelace Westside Hospital', '', '', 'HCFA|UB|', '1609897388', 0, 'N', 0, '2014-06-24', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000225', 'ABQ000225', 'NM01', 'ABQ Health Partners', 'John', '', 'McCormick', 'MD', 'Rheumatology', '', '', NULL, 'O', '5400 Gibson Blvd SE', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052627248', '5052623190', '5400 Gibson Blvd SE', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052627248', '5052623190', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2012-05-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1770590556', 0, 'N', 0, '2012-06-13', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000624', 'ABQ000624', 'NM01', 'ABQ Health Partners', 'John', '', 'McCormick', 'MD', 'Rheumatology', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052627248', '5052623190', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052627248', '5052623190', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2012-05-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1770590556', 0, 'N', 0, '2012-06-13', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000227', 'ABQ000227', 'NM01', 'ABQ Health Partners', 'Thomas', '', 'McEnnerney', 'MD', 'Orthopedic Surgery', '', '', NULL, 'O', '10511 Golf Course Rd NW Ste 103', 'Albuquerque', 'Bernalillo', 'NM', '87114', '5053428400', '5053428401', '10511 Golf Course Rd NW Ste 103', 'Albuquerque', 'Bernalillo', 'NM', '87114', '5053428400', '5053428401', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Womens Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1851325054', 0, 'N', 0, '2011-10-20', NULL, NULL, 35.2073, -106.676, NULL, NULL),
('204043287', 'ABQ001026', 'ABQ001026', 'NM01', 'ABQ Health Partners', 'Thomas', '', 'McEnnerney', 'MD', 'Orthopedic Surgery', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5053428400', '5053428401', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5053428400', '5053428401', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Womens Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1851325054', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000626', 'ABQ000626', 'NM01', 'ABQ Health Partners', 'Thomas', '', 'McEnnerney', 'MD', 'Orthopedic Surgery', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5053428400', '5053428401', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5053428400', '5053428401', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Womens Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1851325054', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000228', 'ABQ000228', 'NM01', 'ABQ Health Partners', 'Toni', '', 'McFadden', 'NP', 'Hospitalist', '', '', NULL, 'O', '500 Walter St NE Ste 401', 'Albuquerque', 'Bernalillo', 'NM', '87102', '5057278039', '5057278086', '500 Walter St NE Ste 401', 'Albuquerque', 'Bernalillo', 'NM', '87102', '5057278039', '5057278086', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Medical Center', 'Lovelace Womens Hospital', 'Lovelace Westside Hospital ', NULL, 'HCFA|UB|', '1205859311', 0, 'N', 0, '2014-06-13', NULL, NULL, 35.0863, -106.64, NULL, NULL),
('204043287', 'ABQ001028', 'ABQ001028', 'NM01', 'ABQ Health Partners', 'Toni', '', 'McFadden', 'NP', 'Hospitalist', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5057278039', '5057278086', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5057278039', '5057278086', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Medical Center', 'Lovelace Womens Hospital', 'Lovelace Westside Hospital ', NULL, 'HCFA|UB|', '1205859311', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000628', 'ABQ000628', 'NM01', 'ABQ Health Partners', 'Toni', '', 'McFadden', 'NP', 'Hospitalist', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5057278039', '5057278086', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5057278039', '5057278086', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Medical Center', 'Lovelace Womens Hospital', 'Lovelace Westside Hospital ', NULL, 'HCFA|UB|', '1205859311', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000232', 'ABQ000232', 'NM01', 'ABQ Health Partners', 'Roderick', '', 'McVeety', 'MD', 'Urgent Care', '', '', NULL, 'O', '5150 Journal Ctr Blvd NE', 'Albuquerque', 'Bernalillo', 'NM', '87109', '5052623233', '5052623191', '5150 Journal Center Blvd NE', 'Albuquerque', 'Bernalillo', 'NM', '87109', '5052623233', '5052623191', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Womens Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1558384735', 0, 'Y', 0, '2012-01-17', NULL, NULL, 35.1702, -106.586, NULL, NULL),
('204043287', 'ABQ001029', 'ABQ001029', 'NM01', 'ABQ Health Partners', 'Roderick', '', 'McVeety', 'MD', 'Urgent Care', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5058968604', '5058968697', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5058968604', '5058968697', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Womens Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1558384735', 0, 'N', 0, '2012-01-17', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000629', 'ABQ000629', 'NM01', 'ABQ Health Partners', 'Roderick', '', 'McVeety', 'MD', 'Urgent Care', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5058968604', '5058968697', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5058968604', '5058968697', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Womens Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1558384735', 0, 'N', 0, '2012-01-17', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000233', 'ABQ000233', 'NM01', 'ABQ Health Partners', 'Richard', '', 'Meredick Jr', 'MD', 'Orthopedic Surgery', '', '', NULL, 'O', '5150 Journal Ctr Blvd NE', 'Albuquerque', 'Bernalillo', 'NM', '87109', '5053428400', '5053428401', '5150 Journal Ctr Blvd NE', 'Albuquerque', 'Bernalillo', 'NM', '87109', '5053428400', '5053428401', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2013-11-02', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1841498763', 0, 'N', 0, '2013-10-14', NULL, NULL, 0, 0, NULL, NULL);
INSERT INTO `providers_new` (`Provider_Tax_ID`, `Provider_Suffix`, `Provider_Network_ID`, `Provider_Region`, `Provider_Name`, `Provider_Doctor_First_Name`, `Provider_Doctor_Middle_Name`, `Provider_Doctor_Last_Name`, `Provider_Doctor_Degree`, `Provider_Specialty_1`, `Provider_Specialty_2`, `Provider_Specialty_3`, `Provider_Specialty_4`, `Provider_Address_Type`, `Provider_Address`, `Provider_City`, `Provider_County`, `Provider_State`, `Provider_Zip`, `Provider_Phone`, `Provider_Fax`, `Provider_Mailing_Address`, `Provider_Mailing_City`, `Provider_Mailing_County`, `Provider_Mailing_State`, `Provider_Mailing_Zip`, `Provider_Mailing_Phone`, `Provider_Mailing_Fax`, `Provider_Primary_Schedule`, `Provider_Secondary_Schedule`, `Provider_Rate_Sheet`, `Provider_Anes_Rate`, `Provider_Default_Rate`, `Provider_Max_DOS`, `Provider_Min_Match_Value`, `Provider_Effective_Date`, `Provider_Term_Date`, `Provider_Pend`, `Provider_Anes_Minutes`, `Provider_PPO`, `Provider_Hospital_1`, `Provider_Hospital_2`, `Provider_Hospital_3`, `Provider_Hospital_4`, `Provider_Type`, `Provider_NPI`, `Provider_Check_Override`, `Exclude_Dir`, `Audit_Status`, `Last_Change_Date`, `Medicare_ID`, `Provider_Lang`, `Provider_Latitude`, `Provider_Longitude`, `Provider_school`, `Provider_cert`) VALUES
('204043287', 'ABQ001033', 'ABQ001033', 'NM01', 'ABQ Health Partners', 'Richard', '', 'Meredick Jr', 'MD', 'Orthopedic Surgery', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5053428400', '5053428401', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5053428400', '5053428401', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2013-11-02', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1841498763', 0, 'N', 0, '2013-10-14', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000633', 'ABQ000633', 'NM01', 'ABQ Health Partners', 'Richard', '', 'Meredick Jr', 'MD', 'Orthopedic Surgery', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5053428400', '5053428401', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5053428400', '5053428401', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2013-11-02', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1841498763', 0, 'N', 0, '2013-10-14', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000234', 'ABQ000234', 'NM01', 'ABQ Health Partners', 'Edward', '', 'Miller', 'DO', 'Obstetrics and Gynecology', '', '', NULL, 'O', '5150 Journal Center Blvd NE', 'Albuquerque', 'Bernalillo', 'NM', '87109', '5052546500', '5052623198', '5150 Journal Center Blvd NE', 'Albuquerque', 'Bernalillo', 'NM', '87109', '5052546500', '5052623198', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2012-01-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1003817263', 0, 'N', 0, '2012-01-17', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ001034', 'ABQ001034', 'NM01', 'ABQ Health Partners', 'Edward', '', 'Miller', 'DO', 'Obstetrics and Gynecology', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052546500', '5052623198', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052546500', '5052623198', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2012-01-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1003817263', 0, 'N', 0, '2012-01-17', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000634', 'ABQ000634', 'NM01', 'ABQ Health Partners', 'Edward', '', 'Miller', 'DO', 'Obstetrics and Gynecology', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052546500', '5052623198', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052546500', '5052623198', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2012-01-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1003817263', 0, 'N', 0, '2012-01-17', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000235', 'ABQ000235', 'NM01', 'ABQ Health Partners', 'Katrine', '', 'Mitchell', 'DPM', 'Podiatry', '', '', NULL, 'O', '10511 Golf Course Rd NW Ste 103', 'Albuquerque', 'Bernalillo', 'NM', '87114', '5052321140', '5052321141', '10511 Golf Course Rd NW Ste 103', 'Albuquerque', 'Bernalillo', 'NM', '87114', '5052321140', '5052321141', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1396857355', 0, 'N', 0, '2011-10-20', NULL, NULL, 35.2073, -106.676, NULL, NULL),
('204043287', 'ABQ001035', 'ABQ001035', 'NM01', 'ABQ Health Partners', 'Katrine', '', 'Mitchell', 'DPM', 'Podiatry', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052321140', '5052321141', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052321140', '5052321141', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1396857355', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000635', 'ABQ000635', 'NM01', 'ABQ Health Partners', 'Katrine', '', 'Mitchell', 'DPM', 'Podiatry', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052321140', '5052321141', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052321140', '5052321141', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1396857355', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000236', 'ABQ000236', 'NM01', 'ABQ Health Partners', 'Lauri', '', 'Montanez', 'NP', 'Pulmonary', '', '', NULL, 'O', '500 Walter St NE Ste 205', 'Albuquerque', 'Bernalillo', 'NM', '87102', '5052627223', '5052627450', '500 Walter St NE Ste 205', 'Albuquerque', 'Bernalillo', 'NM', '87102', '5052627223', '5052627450', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Medical Center', 'Lovelace Womens Hospital', 'Lovelace Westside Hospital ', NULL, 'HCFA|UB|', '1225104946', 0, 'N', 0, '2011-10-20', NULL, NULL, 35.0863, -106.64, NULL, NULL),
('204043287', 'ABQ001036', 'ABQ001036', 'NM01', 'ABQ Health Partners', 'Lauri', '', 'Montanez', 'NP', 'Pulmonary', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052627223', '5052627450', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052627223', '5052627450', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Medical Center', 'Lovelace Womens Hospital', 'Lovelace Westside Hospital ', NULL, 'HCFA|UB|', '1225104946', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000636', 'ABQ000636', 'NM01', 'ABQ Health Partners', 'Lauri', '', 'Montanez', 'NP', 'Pulmonary', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052627223', '5052627450', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052627223', '5052627450', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Medical Center', 'Lovelace Womens Hospital', 'Lovelace Westside Hospital ', NULL, 'HCFA|UB|', '1225104946', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000237', 'ABQ000237', 'NM01', 'ABQ Health Partners', 'Jeffrey', '', 'Morehouse', 'MD', 'Plastic Surgery', '', ' ', NULL, 'O', '5006 Gibson Blvd SE', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052627777', '5052627959', '5006 Gibson Blvd SE', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052627777', '5052627959', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Womens Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1487687067', 0, 'N', 0, '2013-11-15', NULL, NULL, 35.0583, -106.586, NULL, NULL),
('204043287', 'ABQ001037', 'ABQ001037', 'NM01', 'ABQ Health Partners', 'Jeffrey', '', 'Morehouse', 'MD', 'Plastic Surgery', '', ' ', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052627777', '5052627959', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052627777', '5052627959', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Womens Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1487687067', 0, 'N', 0, '2013-11-15', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000637', 'ABQ000637', 'NM01', 'ABQ Health Partners', 'Jeffrey', '', 'Morehouse', 'MD', 'Plastic Surgery', '', ' ', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052627777', '5052627959', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052627777', '5052627959', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Womens Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1487687067', 0, 'N', 0, '2013-11-15', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000238', 'ABQ000238', 'NM01', 'ABQ Health Partners', 'Kanyinda', '', 'Mpoy', 'MD', 'Internal Medicine', '', '', NULL, 'O', '1721 Rio Rancho Blvd SE', 'Rio Rancho', 'Sandoval', 'NM', '87124', '5058968600', '5058968618', '1721 Rio Rancho Blvd SE', 'Rio Rancho', 'Sandoval', 'NM', '87124', '5058968600', '5058968618', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2013-10-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1700809894', 0, 'N', 0, '2013-09-18', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ001038', 'ABQ001038', 'NM01', 'ABQ Health Partners', 'Kanyinda', '', 'Mpoy', 'MD', 'Internal Medicine', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5058968600', '5058968618', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5058968600', '5058968618', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2013-10-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1700809894', 0, 'N', 0, '2013-09-18', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000638', 'ABQ000638', 'NM01', 'ABQ Health Partners', 'Kanyinda', '', 'Mpoy', 'MD', 'Internal Medicine', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5058968600', '5058968618', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5058968600', '5058968618', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2013-10-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1700809894', 0, 'N', 0, '2013-09-18', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000239', 'ABQ000239', 'NM01', 'ABQ Health Partners', 'Julie', '', 'Muche', 'MD', 'Pain Management', '', '', NULL, 'O', '5310 Homestead Rd NE Ste 201', 'Albuquerque', 'Bernalillo', 'NM', '87110', '5052627724', '5052623476', '5310 Homestead Rd NE Ste 201', 'Albuquerque', 'Bernalillo', 'NM', '87110', '5052627724', '5052623476', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Westside Hospital', 'Lovelace Medical Center', NULL, NULL, 'HCFA|UB|', '1033116298', 0, 'N', 0, '2013-09-04', NULL, NULL, 35.1289, -106.584, NULL, NULL),
('204043287', 'ABQ001039', 'ABQ001039', 'NM01', 'ABQ Health Partners', 'Julie', '', 'Muche', 'MD', 'Pain Management', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052627724', '5052623476', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052627724', '5052623476', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Westside Hospital', 'Lovelace Medical Center', NULL, NULL, 'HCFA|UB|', '1033116298', 0, 'N', 0, '2013-09-04', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000639', 'ABQ000639', 'NM01', 'ABQ Health Partners', 'Julie', '', 'Muche', 'MD', 'Pain Management', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052627724', '5052623476', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052627724', '5052623476', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Westside Hospital', 'Lovelace Medical Center', NULL, NULL, 'HCFA|UB|', '1033116298', 0, 'N', 0, '2013-09-04', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000240', 'ABQ000240', 'NM01', 'ABQ Health Partners', 'Tracie', '', 'Mudge', 'CNP', 'Cardiovascular Disease', '', '', NULL, 'O', '500 Walter St NE Ste 401', 'Albuquerque', 'Bernalillo', 'NM', '87102', '5052627451', '5052627870', '500 Walter St NE Ste 401', 'Albuquerque', 'Bernalillo', 'NM', '87102', '5052627451', '5052627870', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2012-01-20', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1598740805', 0, 'N', 0, '2012-01-18', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ001040', 'ABQ001040', 'NM01', 'ABQ Health Partners', 'Tracie', '', 'Mudge', 'CNP', 'Cardiovascular Disease', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052627451', '5052627870', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052627451', '5052627870', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2012-01-20', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1598740805', 0, 'N', 0, '2012-01-18', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000640', 'ABQ000640', 'NM01', 'ABQ Health Partners', 'Tracie', '', 'Mudge', 'CNP', 'Cardiovascular Disease', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052627451', '5052627870', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052627451', '5052627870', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2012-01-20', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1598740805', 0, 'N', 0, '2012-01-18', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000241', 'ABQ000241', 'NM01', 'ABQ Health Partners', 'Lori', '', 'Myers', 'CNP', 'Pediatrics', '', '', NULL, 'O', '1721 Rio Rancho Blvd SE', 'Rio Rancho', 'Sandoval', 'NM', '87124', '5058968600', '5057273505', '1721 Rio Rancho Blvd SE', 'Rio Rancho', 'Sandoval', 'NM', '87124', '5058968600', '5057273505', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1891026563', 0, 'N', 0, '2011-10-20', NULL, NULL, 35.2284, -106.66, NULL, NULL),
('204043287', 'ABQ001041', 'ABQ001041', 'NM01', 'ABQ Health Partners', 'Lori', '', 'Myers', 'CNP', 'Pediatrics', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5058968600', '5057273505', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5058968600', '5057273505', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1891026563', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000641', 'ABQ000641', 'NM01', 'ABQ Health Partners', 'Lori', '', 'Myers', 'CNP', 'Pediatrics', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5058968600', '5057273505', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5058968600', '5057273505', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1891026563', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000242', 'ABQ000242', 'NM01', 'ABQ Health Partners', 'Daniel', '', 'Nazon', 'MD', 'Pulmonary', '', '', NULL, 'O', '500 Walter St NE Ste 205', 'Albuquerque', 'Bernalillo', 'NM', '87102', '5052627223', '5052627450', '500 Walter St NE Ste 205', 'Albuquerque', 'Bernalillo', 'NM', '87102', '5052627223', '5052627450', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Medical Center', 'Lovelace Womens Hospital', 'Lovelace Westside Hospital ', NULL, 'HCFA|UB|', '1386676476', 0, 'N', 0, '2011-10-20', NULL, NULL, 35.0863, -106.64, NULL, NULL),
('204043287', 'ABQ001042', 'ABQ001042', 'NM01', 'ABQ Health Partners', 'Daniel', '', 'Nazon', 'MD', 'Pulmonary', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052627223', '5052627450', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052627223', '5052627450', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Medical Center', 'Lovelace Womens Hospital', 'Lovelace Westside Hospital ', NULL, 'HCFA|UB|', '1386676476', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000642', 'ABQ000642', 'NM01', 'ABQ Health Partners', 'Daniel', '', 'Nazon', 'MD', 'Pulmonary', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052627223', '5052627450', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052627223', '5052627450', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Medical Center', 'Lovelace Womens Hospital', 'Lovelace Westside Hospital ', NULL, 'HCFA|UB|', '1386676476', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000245', 'ABQ000245', 'NM01', 'ABQ Health Partners', 'G. David', '', 'Neal', 'MD', 'Ear, Nose and Throat', '', '', NULL, 'O', '10511 Golf Course Rd NW Ste 105', 'Albuquerque', 'Bernalillo', 'NM', '87114', '5052321170', '5052627217', '10511 Golf Course Rd NW Ste 105', 'Albuquerque', 'Bernalillo', 'NM', '87114', '5052321170', '5052627217', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1235164344', 0, 'N', 0, '2011-10-20', NULL, NULL, 35.2073, -106.676, NULL, NULL),
('204043287', 'ABQ000643', 'ABQ000643', 'NM01', 'ABQ Health Partners', 'G. David', '', 'Neal', 'MD', 'Ear, Nose and Throat', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052627905', '5052627217', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052627905', '5052627217', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1235164344', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000246', 'ABQ000246', 'NM01', 'ABQ Health Partners', 'Gary', '', 'Nelson', 'DPM', 'Podiatry', '', '', NULL, 'O', '5400 Gibson Blvd SE', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052627285', '5052623988', '5400 Gibson Blvd SE', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052627285', '5052623988', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1447273552', 0, 'N', 0, '2011-10-20', NULL, NULL, 35.0583, -106.582, NULL, NULL),
('204043287', 'ABQ000646', 'ABQ000646', 'NM01', 'ABQ Health Partners', 'Gary', '', 'Nelson', 'DPM', 'Podiatry', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052627285', '5052623988', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052627285', '5052623988', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1447273552', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ001047', 'ABQ001047', 'NM01', 'ABQ Health Partners', 'Marlyn', '', 'Newby', 'NP', 'Family Practice', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052754288', '5052754203', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052754288', '5052754203', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1629091731', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000247', 'ABQ000247', 'NM01', 'ABQ Health Partners', 'Marlyn', '', 'Newby', 'NP', 'Family Practice', '', '', NULL, 'O', '9101 Montgomery Blvd NE', 'Albuquerque', 'Bernalillo', 'NM', '87111', '5052754288', '5052754203', '9101 Montgomery Blvd NE', 'Albuquerque', 'Bernalillo', 'NM', '87111', '5052754288', '5052754203', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1629091731', 0, 'N', 0, '2011-10-20', NULL, NULL, 35.1307, -106.542, NULL, NULL),
('204043287', 'ABQ000647', 'ABQ000647', 'NM01', 'ABQ Health Partners', 'Marlyn', '', 'Newby', 'NP', 'Family Practice', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052754288', '5052754203', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052754288', '5052754203', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1629091731', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000248', 'ABQ000248', 'NM01', 'ABQ Health Partners', 'Gerhard', '', 'Nyase', 'MD', 'Family Practice', '', '', NULL, 'O', '3901 Carlisle Blvd NE', 'Albuquerque', 'Bernalillo', 'NM', '87107', '5058888500', '5058888503', '3901 Carlisle Blvd NE', 'Albuquerque', 'Bernalillo', 'NM', '87107', '5058888500', '5058888503', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1114940822', 0, 'N', 0, '2011-10-20', NULL, NULL, 35.1252, -106.604, NULL, NULL),
('204043287', 'ABQ001048', 'ABQ001048', 'NM01', 'ABQ Health Partners', 'Gerhard', '', 'Nyase', 'MD', 'Family Practice', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5058888500', '5058888503', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5058888500', '5058888503', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1114940822', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000648', 'ABQ000648', 'NM01', 'ABQ Health Partners', 'Gerhard', '', 'Nyase', 'MD', 'Family Practice', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5058888500', '5058888503', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5058888500', '5058888503', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1114940822', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000252', 'ABQ000252', 'NM01', 'ABQ Health Partners', 'Alexander', '', 'Orbon', 'PA-C', 'Urgent Care', '', '', NULL, 'O', '5150 Journal Center Blvd NE', 'Albuquerque', 'Bernalillo', 'NM', '87109', '5052623233', '5052623191', '5150 Journal Center Blvd NE', 'Albuquerque', 'Bernalillo', 'NM', '87109', '5052623233', '5052623191', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2012-01-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1235303041', 0, 'Y', 0, '2012-01-17', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ001049', 'ABQ001049', 'NM01', 'ABQ Health Partners', 'Alexander', '', 'Orbon', 'PA-C', 'Urgent Care', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5058968604', '5058968697', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5058968604', '5058968697', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2012-01-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1235303041', 0, 'N', 0, '2012-01-17', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000649', 'ABQ000649', 'NM01', 'ABQ Health Partners', 'Alexander', '', 'Orbon', 'PA-C', 'Urgent Care', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5058968604', '5058968697', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5058968604', '5058968697', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2012-01-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1235303041', 0, 'N', 0, '2012-01-17', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000254', 'ABQ000254', 'NM01', 'ABQ Health Partners', 'Pedro', '', 'Ortiz', 'MD', 'Cardiology', '', '', NULL, 'O', '500 Walter St NE Ste 401', 'Albuquerque', 'Bernalillo', 'NM', '87102', '5052627451', '5052627870', '500 Walter St NE Ste 401', 'Albuquerque', 'Bernalillo', 'NM', '87102', '5052627451', '5052627870', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Medical Center', 'Lovelace Womens Hospital', 'Lovelace Westside Hospital ', NULL, 'HCFA|UB|', '1659463362', 0, 'N', 0, '2012-07-06', NULL, NULL, 35.0863, -106.64, NULL, NULL),
('204043287', 'ABQ001053', 'ABQ001053', 'NM01', 'ABQ Health Partners', 'Pedro', '', 'Ortiz', 'MD', 'Cardiology', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052321130', '5052322234', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052321130', '5052322234', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Medical Center', 'Lovelace Womens Hospital', 'Lovelace Westside Hospital ', NULL, 'HCFA|UB|', '1659463362', 0, 'N', 0, '2012-07-06', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000653', 'ABQ000653', 'NM01', 'ABQ Health Partners', 'Pedro', '', 'Ortiz', 'MD', 'Cardiology', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052321130', '5052322234', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052321130', '5052322234', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Medical Center', 'Lovelace Womens Hospital', 'Lovelace Westside Hospital ', NULL, 'HCFA|UB|', '1659463362', 0, 'N', 0, '2012-07-06', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ001057', 'ABQ001057', 'NM01', 'ABQ Health Partners', 'David', '', 'Paolini', 'MD', 'Vascular Surgery', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052627281', '5052627622', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052627281', '5052627622', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2012-11-30', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1245229004', 0, 'N', 0, '2012-12-11', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000257', 'ABQ000257', 'NM01', 'ABQ Health Partners', 'David', '', 'Paolini', 'MD', 'Vascular Surgery', '', '', NULL, 'O', '715 Martin Luther King Jr. Ave NE Ste 301', 'Albuquerque', 'Bernalillo', 'NM', '87102', '5052627281', '5052627622', '715 Martin Luther King Jr. Ave NE Ste 301', 'Albuquerque', 'Bernalillo', 'NM', '87102', '5052627281', '5052627622', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2012-01-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1245229004', 0, 'Y', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000657', 'ABQ000657', 'NM01', 'ABQ Health Partners', 'David', '', 'Paolini', 'MD', 'Vascular Surgery', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052627281', '5052627622', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052627281', '5052627622', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2012-11-30', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1245229004', 0, 'N', 0, '2012-12-11', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000258', 'ABQ000258', 'NM01', 'ABQ Health Partners', 'Laura', '', 'Parker', 'CNP', 'Gastroenterology', '', '', NULL, 'O', '5400 Gibson Blvd SE', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052627174', '5052623562', '5400 Gibson Blvd SE', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052627174', '5052623562', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2012-12-28', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1235344581', 0, 'N', 0, '2012-12-26', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000658', 'ABQ000658', 'NM01', 'ABQ Health Partners', 'Laura', '', 'Parker', 'CNP', 'Gastroenterology', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052627174', '5052623562', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052627174', '5052623562', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2012-12-28', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1235344581', 0, 'N', 0, '2012-12-26', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000259', 'ABQ000259', 'NM01', 'ABQ Health Partners', 'Robert', '', 'Parks', 'DPM', 'Podiatry', '', '', NULL, 'O', '5150 Journal Ctr Blvd NE', 'Albuquerque', 'Bernalillo', 'NM', '87109', '5052321530', '5052623380', '5150 Journal Center Blvd NE', 'Albuquerque', 'Bernalillo', 'NM', '87109', '5052321530', '5052623380', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1336162445', 0, 'N', 0, '2011-10-20', NULL, NULL, 35.1702, -106.586, NULL, NULL),
('204043287', 'ABQ001059', 'ABQ001059', 'NM01', 'ABQ Health Partners', 'Robert', '', 'Parks', 'DPM', 'Podiatry', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052321530', '5052623380', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052321530', '5052623380', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1336162445', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000659', 'ABQ000659', 'NM01', 'ABQ Health Partners', 'Robert', '', 'Parks', 'DPM', 'Podiatry', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052321530', '5052623380', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052321530', '5052623380', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1336162445', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000260', 'ABQ000260', 'NM01', 'ABQ Health Partners', 'Gregory', '', 'Pendle', 'PA-C', 'Hospitalist', '', '', NULL, 'O', '500 Walter St NE Ste 401', 'Albuquerque', 'Bernalillo', 'NM', '87102', '5057278039', '5057278086', '500 Walter St NE Ste 401', 'Albuquerque', 'Bernalillo', 'NM', '87102', '5057278039', '5057278086', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Medical Center', 'Lovelace Womens Hospital', 'Lovelace Westside Hospital ', NULL, 'HCFA|UB|', '1174780282', 0, 'N', 0, '2014-06-13', NULL, NULL, 35.0863, -106.64, NULL, NULL),
('204043287', 'ABQ001060', 'ABQ001060', 'NM01', 'ABQ Health Partners', 'Gregory', '', 'Pendle', 'PA-C', 'Hospitalist', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5057278039', '5057278086', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5057278039', '5057278086', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Medical Center', 'Lovelace Womens Hospital', 'Lovelace Westside Hospital ', NULL, 'HCFA|UB|', '1174780282', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000660', 'ABQ000660', 'NM01', 'ABQ Health Partners', 'Gregory', '', 'Pendle', 'PA-C', 'Hospitalist', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5057278039', '5057278086', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5057278039', '5057278086', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Medical Center', 'Lovelace Womens Hospital', 'Lovelace Westside Hospital ', NULL, 'HCFA|UB|', '1174780282', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000261', 'ABQ000261', 'NM01', 'ABQ Health Partners', 'Vicky', '', 'Peng', 'MD', 'Obstetrics and Gynecology', '', '', NULL, 'O', '4705 Montgomery Blvd NE Ste 301-302', 'Albuquerque', 'Bernalillo', 'NM', '87109', '5052546500', '5052546532', '4705 Montgomery Blvd NE Ste 301-302', 'Albuquerque', 'Bernalillo', 'NM', '87109', '5052546500', '5052546532', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2013-09-03', 0, 0, 0, 'Lovelace Womens Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1689607178', 0, 'N', 0, '2013-09-09', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ001061', 'ABQ001061', 'NM01', 'ABQ Health Partners', 'Vicky', '', 'Peng', 'MD', 'Obstetrics and Gynecology', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052546500', '5052546532', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052546500', '5052546532', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Womens Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1689607178', 0, 'N', 0, '2013-09-09', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000661', 'ABQ000661', 'NM01', 'ABQ Health Partners', 'Vicky', '', 'Peng', 'MD', 'Obstetrics and Gynecology', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052546500', '5052546532', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052546500', '5052546532', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Womens Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1689607178', 0, 'N', 0, '2013-09-09', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ001062', 'ABQ001062', 'NM01', 'ABQ Health Partners', 'Oswaldo', '', 'Pereira', 'MD', 'Family Practice', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052754288', '5052754203', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052754288', '5052754203', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Medical Center', 'Lovelace Womens Hospital', 'Lovelace Westside Hospital ', NULL, 'HCFA|UB|', '1194758789', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000262', 'ABQ000262', 'NM01', 'ABQ Health Partners', 'Oswaldo', '', 'Pereira', 'MD', 'Family Practice', '', '', NULL, 'O', '9101 Montgomery Blvd NE', 'Albuquerque', 'Bernalillo', 'NM', '87111', '5052754288', '5052754203', '9101 Montgomery Blvd NE', 'Albuquerque', 'Bernalillo', 'NM', '87111', '5052754288', '5052754203', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Medical Center', 'Lovelace Womens Hospital', 'Lovelace Westside Hospital ', NULL, 'HCFA|UB|', '1194758789', 0, 'N', 0, '2011-10-20', NULL, NULL, 35.1307, -106.542, NULL, NULL),
('204043287', 'ABQ000662', 'ABQ000662', 'NM01', 'ABQ Health Partners', 'Oswaldo', '', 'Pereira', 'MD', 'Family Practice', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052754288', '5052754203', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052754288', '5052754203', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Medical Center', 'Lovelace Womens Hospital', 'Lovelace Westside Hospital ', NULL, 'HCFA|UB|', '1194758789', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000264', 'ABQ000264', 'NM01', 'ABQ Health Partners', 'Richard', '', 'Puhl', 'DPM', 'Podiatry', '', '', NULL, 'O', '5150 Journal Ctr Blvd NE', 'Albuquerque', 'Bernalillo', 'NM', '87109', '5052321530', '5052623380', '5150 Journal Center Blvd NE', 'Albuquerque', 'Bernalillo', 'NM', '87109', '5052321530', '5052623380', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1588678338', 0, 'N', 0, '2011-10-20', NULL, NULL, 35.1702, -106.586, NULL, NULL),
('204043287', 'ABQ000663', 'ABQ000663', 'NM01', 'ABQ Health Partners', 'Richard', '', 'Puhl', 'DPM', 'Podiatry', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052321530', '5052623380', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052321530', '5052623380', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1588678338', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000266', 'ABQ000266', 'NM01', 'ABQ Health Partners', 'Mario', '', 'Quesada', 'MD', 'Orthopedic Surgery', '', '', NULL, 'O', '10511 Golf Course Rd NW Ste 103', 'Albuquerque', 'Bernalillo', 'NM', '87114', '5053428400', '5053428401', '10511 Golf Course Rd NW Ste 103', 'Albuquerque', 'Bernalillo', 'NM', '87114', '5053428400', '5053428401', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2012-01-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1003018086', 0, 'N', 0, '2012-01-17', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ001065', 'ABQ001065', 'NM01', 'ABQ Health Partners', 'Mario', '', 'Quesada', 'MD', 'Orthopedic Surgery', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5053428400', '5053428401', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5053428400', '5053428401', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2012-01-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1003018086', 0, 'N', 0, '2012-01-17', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000665', 'ABQ000665', 'NM01', 'ABQ Health Partners', 'Mario', '', 'Quesada', 'MD', 'Orthopedic Surgery', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5053428400', '5053428401', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5053428400', '5053428401', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2012-01-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1003018086', 0, 'N', 0, '2012-01-17', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000267', 'ABQ000267', 'NM01', 'ABQ Health Partners', 'Ana-Maria', '', 'Rael', 'MD', 'Family Practice', '', '', NULL, 'O', '2929 Coors Blvd NW Ste 200', 'Albuquerque', 'Bernalillo', 'NM', '87120', '5058392300', '5058392303', '2929 Coors Blvd NW Ste 200', 'Albuquerque', 'Bernalillo', 'NM', '87120', '5058392300', '5058392303', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Westside Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1457385338', 0, 'N', 0, '2011-10-20', NULL, NULL, 35.1168, -106.702, NULL, NULL),
('204043287', 'ABQ001067', 'ABQ001067', 'NM01', 'ABQ Health Partners', 'Ana-Maria', '', 'Rael', 'MD', 'Family Practice', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5058392300', '5058392303', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5058392300', '5058392303', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Westside Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1457385338', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000667', 'ABQ000667', 'NM01', 'ABQ Health Partners', 'Ana-Maria', '', 'Rael', 'MD', 'Family Practice', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5058392300', '5058392303', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5058392300', '5058392303', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Westside Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1457385338', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000271', 'ABQ000271', 'NM01', 'ABQ Health Partners', 'Ellen', '', 'Raimer', 'MD', 'Urgent Care', '', '', NULL, 'O', '200 Rio Bravo Blvd SE', 'Albuquerque', 'Bernalillo', 'NM', '87105', '5058736401', '5058736408', '200 Rio Bravo Blvd SE', 'Albuquerque', 'Bernalillo', 'NM', '87105', '5058736401', '5058736408', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2012-01-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1962557926', 0, 'Y', 0, '2012-01-17', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ001068', 'ABQ001068', 'NM01', 'ABQ Health Partners', 'Ellen', '', 'Raimer', 'MD', 'Urgent Care', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5058968604', '5058968697', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5058968604', '5058968697', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1962557926', 0, 'N', 0, '2012-01-17', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000668', 'ABQ000668', 'NM01', 'ABQ Health Partners', 'Ellen', '', 'Raimer', 'MD', 'Urgent Care', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5058968604', '5058968697', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5058968604', '5058968697', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1962557926', 0, 'N', 0, '2012-01-17', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000272', 'ABQ000272', 'NM01', 'ABQ Health Partners', 'Joseph', '', 'Ramirez', 'MD', 'Pediatrics', '', '', NULL, 'O', '2929 Coors Blvd NW Ste 200', 'Albuquerque', 'Bernalillo', 'NM', '87120', '5058392300', '5058392303', '2929 Coors Blvd NW Ste 200', 'Albuquerque', 'Bernalillo', 'NM', '87120', '5058392300', '5058392303', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Westside Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1336174317', 0, 'N', 0, '2011-10-20', NULL, NULL, 35.1168, -106.702, NULL, NULL),
('204043287', 'ABQ001072', 'ABQ001072', 'NM01', 'ABQ Health Partners', 'Joseph', '', 'Ramirez', 'MD', 'Pediatrics', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5058392300', '5058392303', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5058392300', '5058392303', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Westside Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1336174317', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000672', 'ABQ000672', 'NM01', 'ABQ Health Partners', 'Joseph', '', 'Ramirez', 'MD', 'Pediatrics', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5058392300', '5058392303', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5058392300', '5058392303', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Westside Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1336174317', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ001073', 'ABQ001073', 'NM01', 'ABQ Health Partners', 'Carol', '', 'Red', 'MD', 'Family Practice', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052754288', '5052754203', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052754288', '5052754203', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2012-05-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1568495158', 0, 'N', 0, '2012-05-25', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000273', 'ABQ000273', 'NM01', 'ABQ Health Partners', 'Carol', '', 'Red', 'MD', 'Family Practice', '', '', NULL, 'O', '9101 Montgomery Blvd NE', 'Albuquerque', 'Bernalillo', 'NM', '87111', '5052754288', '5052754203', '9101 Montgomery Blvd NE', 'Albuquerque', 'Bernalillo', 'NM', '87111', '5052754288', '5052754203', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2012-05-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1568495158', 0, 'N', 0, '2012-05-25', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000673', 'ABQ000673', 'NM01', 'ABQ Health Partners', 'Carol', '', 'Red', 'MD', 'Family Practice', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052754288', '5052754203', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052754288', '5052754203', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2012-05-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1568495158', 0, 'N', 0, '2012-05-25', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000274', 'ABQ000274', 'NM01', 'ABQ Health Partners', 'Jacquelyn', '', 'Reeve', 'CNP', 'Family Practice', '', '', NULL, 'O', '2121 Juan Tabo Blvd NE', 'Albuquerque', 'Bernalillo', 'NM', '87112', '5052378800', '5052378817', '2121 Juan Tabo Blvd NE', 'Albuquerque', 'Bernalillo', 'NM', '87112', '5052378800', '5052378817', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2012-01-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1043511256', 0, 'N', 0, '2012-01-17', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ001074', 'ABQ001074', 'NM01', 'ABQ Health Partners', 'Jacquelyn', '', 'Reeve', 'CNP', 'Family Practice', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052378800', '5052378817', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052378800', '5052378817', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2012-01-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1043511256', 0, 'N', 0, '2012-01-17', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000674', 'ABQ000674', 'NM01', 'ABQ Health Partners', 'Jacquelyn', '', 'Reeve', 'CNP', 'Family Practice', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052378800', '5052378817', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052378800', '5052378817', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2012-01-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1043511256', 0, 'N', 0, '2012-01-17', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000275', 'ABQ000275', 'NM01', 'ABQ Health Partners', 'Kevin', '', 'Regan', 'PA-C', 'Orthopedic Surgery', '', '', NULL, 'O', '5150 Journal Ctr Blvd NE', 'Albuquerque', 'Bernalillo', 'NM', '87109', '5053428400', '5053428401', '5150 Journal Center Blvd NE', 'Albuquerque', 'Bernalillo', 'NM', '87109', '5053428400', '5053428401', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Womens Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1265524177', 0, 'N', 0, '2011-10-20', NULL, NULL, 35.1702, -106.586, NULL, NULL),
('204043287', 'ABQ001075', 'ABQ001075', 'NM01', 'ABQ Health Partners', 'Kevin', '', 'Regan', 'PA-C', 'Orthopedic Surgery', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5053428400', '5053428401', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5053428400', '5053428401', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Womens Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1265524177', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000675', 'ABQ000675', 'NM01', 'ABQ Health Partners', 'Kevin', '', 'Regan', 'PA-C', 'Orthopedic Surgery', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5053428400', '5053428401', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5053428400', '5053428401', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Womens Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1265524177', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000276', 'ABQ000276', 'NM01', 'ABQ Health Partners', 'Candace', '', 'Reid', 'CNM', 'Obstetrics and Gynecology', '', '', NULL, 'O', '4705 Montgomery Blvd NE Ste 301-302', 'Albuquerque', 'Bernalillo', 'NM', '87109', '5052546500', '5052546532', '4705 Montgomery Blvd NE Ste 301-302', 'Albuquerque', 'Bernalillo', 'NM', '87109', '5052546500', '5052546532', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Womens Hospital', 'Lovelace Westside Hospital', '', '', 'HCFA|UB|', '1700193216', 0, 'N', 0, '2014-06-24', NULL, NULL, 35.131, -106.591, NULL, NULL),
('204043287', 'ABQ001076', 'ABQ001076', 'NM01', 'ABQ Health Partners', 'Candace', '', 'Reid', 'CNM', 'Obstetrics and Gynecology', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052546500', '5052546532', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052546500', '5052546532', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Womens Hospital', 'Lovelace Westside Hospital', '', '', 'HCFA|UB|', '1700193216', 0, 'N', 0, '2014-06-24', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000676', 'ABQ000676', 'NM01', 'ABQ Health Partners', 'Candace', '', 'Reid', 'CNM', 'Obstetrics and Gynecology', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052546500', '5052546532', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052546500', '5052546532', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Womens Hospital', 'Lovelace Westside Hospital', '', '', 'HCFA|UB|', '1700193216', 0, 'N', 0, '2014-06-24', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000277', 'ABQ000277', 'NM01', 'ABQ Health Partners', 'Rebecca', '', 'Reiter', 'NP', 'Obstetrics and Gynecology', '', '', NULL, 'O', '5400 Gibson Blvd SE', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052546500', '5052546532', '5400 Gibson Blvd SE', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052546500', '5052546532', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2012-05-18', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1366475857', 0, 'N', 0, '2012-05-25', NULL, NULL, 0, 0, NULL, NULL);
INSERT INTO `providers_new` (`Provider_Tax_ID`, `Provider_Suffix`, `Provider_Network_ID`, `Provider_Region`, `Provider_Name`, `Provider_Doctor_First_Name`, `Provider_Doctor_Middle_Name`, `Provider_Doctor_Last_Name`, `Provider_Doctor_Degree`, `Provider_Specialty_1`, `Provider_Specialty_2`, `Provider_Specialty_3`, `Provider_Specialty_4`, `Provider_Address_Type`, `Provider_Address`, `Provider_City`, `Provider_County`, `Provider_State`, `Provider_Zip`, `Provider_Phone`, `Provider_Fax`, `Provider_Mailing_Address`, `Provider_Mailing_City`, `Provider_Mailing_County`, `Provider_Mailing_State`, `Provider_Mailing_Zip`, `Provider_Mailing_Phone`, `Provider_Mailing_Fax`, `Provider_Primary_Schedule`, `Provider_Secondary_Schedule`, `Provider_Rate_Sheet`, `Provider_Anes_Rate`, `Provider_Default_Rate`, `Provider_Max_DOS`, `Provider_Min_Match_Value`, `Provider_Effective_Date`, `Provider_Term_Date`, `Provider_Pend`, `Provider_Anes_Minutes`, `Provider_PPO`, `Provider_Hospital_1`, `Provider_Hospital_2`, `Provider_Hospital_3`, `Provider_Hospital_4`, `Provider_Type`, `Provider_NPI`, `Provider_Check_Override`, `Exclude_Dir`, `Audit_Status`, `Last_Change_Date`, `Medicare_ID`, `Provider_Lang`, `Provider_Latitude`, `Provider_Longitude`, `Provider_school`, `Provider_cert`) VALUES
('204043287', 'ABQ000677', 'ABQ000677', 'NM01', 'ABQ Health Partners', 'Rebecca', '', 'Reiter', 'NP', 'Obstetrics and Gynecology', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052546500', '5052546532', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052546500', '5052546532', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2012-05-18', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1366475857', 0, 'N', 0, '2012-05-25', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000278', 'ABQ000278', 'NM01', 'ABQ Health Partners', 'Diletta', '', 'Renier-Berg', 'MD', 'Hospitalist', '', '', NULL, 'O', '500 Walter St NE Ste 401', 'Albuquerque', 'Bernalillo', 'NM', '87102', '5057278039', '5057278086', '500 Walter St NE Ste 401', 'Albuquerque', 'Bernalillo', 'NM', '87102', '5057278039', '5057278086', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Medical Center', 'Lovelace Womens Hospital', 'Lovelace Westside Hospital ', NULL, 'HCFA|UB|', '1912920893', 0, 'N', 0, '2014-06-13', NULL, NULL, 35.0863, -106.64, NULL, NULL),
('204043287', 'ABQ001078', 'ABQ001078', 'NM01', 'ABQ Health Partners', 'Diletta', '', 'Renier-Berg', 'MD', 'Hospitalist', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5057278039', '5057278086', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5057278039', '5057278086', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Medical Center', 'Lovelace Womens Hospital', 'Lovelace Westside Hospital ', NULL, 'HCFA|UB|', '1912920893', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000678', 'ABQ000678', 'NM01', 'ABQ Health Partners', 'Diletta', '', 'Renier-Berg', 'MD', 'Hospitalist', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5057278039', '5057278086', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5057278039', '5057278086', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Medical Center', 'Lovelace Womens Hospital', 'Lovelace Westside Hospital ', NULL, 'HCFA|UB|', '1912920893', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000281', 'ABQ000281', 'NM01', 'ABQ Health Partners', 'Andrew', '', 'Ribner', 'MD', 'Ear, Nose and Throat', '', '', NULL, 'O', '5400 Gibson Blvd SE', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052627905', '5052627217', '5400 Gibson Blvd SE', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052627905', '5052627217', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1467418582', 0, 'N', 0, '2011-10-20', NULL, NULL, 35.0583, -106.582, NULL, NULL),
('204043287', 'ABQ100058', 'ABQ100058', 'NM01', 'ABQ Health Partners', 'Yvonne', '', 'Castillo', 'CNM', 'Obstetrics and Gynecology', '', '', NULL, 'O', '4705 Montgomery Blvd NE Ste 301-302', 'Albuquerque', 'Bernalillo', 'NM', '87109', '5052546500', '5052546532', '4705 Montgomery Blvd NE Ste 301-302', 'Albuquerque', 'Bernalillo', 'NM', '87109', '5052546500', '5052546532', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2013-09-03', 0, 0, 0, 'Lovelace Medical Center', '', '', '', 'HCFA|UB|', '1396778809', 0, 'N', 0, '2014-06-24', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000679', 'ABQ000679', 'NM01', 'ABQ Health Partners', 'Andrew', '', 'Ribner', 'MD', 'Ear, Nose and Throat', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052627905', '5052627217', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052627905', '5052627217', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1467418582', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000282', 'ABQ000282', 'NM01', 'ABQ Health Partners', 'Allison', '', 'Richards', 'DO', 'Hand Surgery', 'Orthopedic Surgery', '', NULL, 'O', '101 Hospital Loop NE Ste 201', 'Albuquerque', 'Bernalillo', 'NM', '87109', '5052627375', '5052627776', '101 Hospital Loop NE Ste 201', 'Albuquerque', 'Bernalillo', 'NM', '87109', '5052627375', '5052627776', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2013-10-01', 0, 0, 0, 'Lovelace Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1891700365', 0, 'N', 0, '2013-09-10', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ001082', 'ABQ001082', 'NM01', 'ABQ Health Partners', 'Allison', '', 'Richards', 'DO', 'Hand Surgery', 'Orthopedic Surgery', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052627375', '5052627776', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052627375', '5052627776', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1891700365', 0, 'N', 0, '2013-09-10', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000682', 'ABQ000682', 'NM01', 'ABQ Health Partners', 'Allison', '', 'Richards', 'DO', 'Hand Surgery', 'Orthopedic Surgery', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052627375', '5052627776', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052627375', '5052627776', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1891700365', 0, 'N', 0, '2013-09-10', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000283', 'ABQ000283', 'NM01', 'ABQ Health Partners', 'Mark', '', 'Rieb', 'MD', 'Family Practice', '', '', NULL, 'O', '13701 Encantado Rd NE', 'Albuquerque', 'Bernalillo', 'NM', '87123', '5052378700', '5052378703', '13701 Encantado Rd NE', 'Albuquerque', 'Bernalillo', 'NM', '87123', '5052378700', '5052378703', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1083698302', 0, 'N', 0, '2011-10-20', NULL, NULL, 35.0743, -106.497, NULL, NULL),
('204043287', 'ABQ001083', 'ABQ001083', 'NM01', 'ABQ Health Partners', 'Mark', '', 'Rieb', 'MD', 'Family Practice', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052378700', '5052378703', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052378700', '5052378703', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1083698302', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000683', 'ABQ000683', 'NM01', 'ABQ Health Partners', 'Mark', '', 'Rieb', 'MD', 'Family Practice', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052378700', '5052378703', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052378700', '5052378703', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1083698302', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000287', 'ABQ000287', 'NM01', 'ABQ Health Partners', 'Josephine', '', 'Roback', 'PA-C', 'Urgent Care', '', '', NULL, 'O', '9101 Montgomery Blvd NE', 'Albuquerque', 'Bernalillo', 'NM', '87111', '5052754259', '5052754223', '9101 Montgomery Blvd NE', 'Albuquerque', 'Bernalillo', 'NM', '87111', '5052754259', '5052754223', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1205859543', 0, 'Y', 0, '2012-01-17', NULL, NULL, 35.1307, -106.542, NULL, NULL),
('204043287', 'ABQ001084', 'ABQ001084', 'NM01', 'ABQ Health Partners', 'Josephine', '', 'Roback', 'PA-C', 'Urgent Care', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5058968604', '5058968697', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5058968604', '5058968697', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1205859543', 0, 'N', 0, '2012-01-17', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000684', 'ABQ000684', 'NM01', 'ABQ Health Partners', 'Josephine', '', 'Roback', 'PA-C', 'Urgent Care', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5058968604', '5058968697', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5058968604', '5058968697', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1205859543', 0, 'N', 0, '2012-01-17', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000288', 'ABQ000288', 'NM01', 'ABQ Health Partners', 'Mirta', '', 'Rodriguez Lugo', 'MD', 'Family Practice', '', '', NULL, 'O', '2929 Coors Blvd NW Ste 200', 'Albuquerque', 'Bernalillo', 'NM', '87120', '5058392300', '5058392303', '2929 Coors Blvd NW Ste 200', 'Albuquerque', 'Bernalillo', 'NM', '87120', '5058392300', '5058392303', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Westside Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1831368026', 0, 'N', 0, '2011-10-20', NULL, NULL, 35.1168, -106.702, NULL, NULL),
('204043287', 'ABQ001088', 'ABQ001088', 'NM01', 'ABQ Health Partners', 'Mirta', '', 'Rodriguez Lugo', 'MD', 'Family Practice', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5058392300', '5058392303', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5058392300', '5058392303', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Westside Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1831368026', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000688', 'ABQ000688', 'NM01', 'ABQ Health Partners', 'Mirta', '', 'Rodriguez Lugo', 'MD', 'Family Practice', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5058392300', '5058392303', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5058392300', '5058392303', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Westside Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1831368026', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000289', 'ABQ000289', 'NM01', 'ABQ Health Partners', 'Ana Lisa', '', 'Rodriguez-Lopez', 'MD', 'Family Practice', '', '', NULL, 'O', '1721 Rio Rancho Blvd SE', 'Rio Rancho', 'Sandoval', 'NM', '87124', '5058968600', '5058968618', '1721 Rio Rancho Blvd SE', 'Rio Rancho', 'Sandoval', 'NM', '87124', '5058968600', '5058968618', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2013-08-30', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1730112236', 0, 'N', 0, '2013-08-15', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ001089', 'ABQ001089', 'NM01', 'ABQ Health Partners', 'Ana Lisa', '', 'Rodriguez-Lopez', 'MD', 'Family Practice', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5058968600', '5058968618', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5058968600', '5058968618', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2013-08-30', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1730112236', 0, 'N', 0, '2013-08-15', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000689', 'ABQ000689', 'NM01', 'ABQ Health Partners', 'Ana Lisa', '', 'Rodriguez-Lopez', 'MD', 'Family Practice', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5058968600', '5058968618', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5058968600', '5058968618', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2013-08-30', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1730112236', 0, 'N', 0, '2013-08-15', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000290', 'ABQ000290', 'NM01', 'ABQ Health Partners', 'Walter', '', 'Rohloff', 'MD', 'Internal Medicine', 'Nephrology', '', NULL, 'O', '500 Walter St NE Ste 309', 'Albuquerque', 'Bernalillo', 'NM', '87102', '5052623542', '5052627394', '500 Walter St NE Ste 309', 'Albuquerque', 'Bernalillo', 'NM', '87102', '5052623542', '5052627394', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2014-03-24', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1649292640', 0, 'Y', 0, '2014-04-29', NULL, NULL, 35.0863, -106.64, NULL, NULL),
('204043287', 'ABQ001090', 'ABQ001090', 'NM01', 'ABQ Health Partners', 'Walter', '', 'Rohloff', 'MD', 'Internal Medicine', 'Nephrology', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052627960', '5052321368', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052627960', '5052321368', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2014-03-24', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1649292640', 0, 'N', 0, '2014-04-29', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000690', 'ABQ000690', 'NM01', 'ABQ Health Partners', 'Walter', '', 'Rohloff', 'MD', 'Internal Medicine', 'Nephrology', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052627600', '0000000000', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052627600', '0000000000', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2014-03-24', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1649292640', 0, 'N', 0, '2014-04-29', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000291', 'ABQ000291', 'NM01', 'ABQ Health Partners', 'Warren', '', 'Rorebeck', 'OD', 'Optometry', '', '', NULL, 'O', '5150 Journal Ctr Blvd NE', 'Albuquerque', 'Bernalillo', 'NM', '87109', '5052623937', '5052623366', '5150 Journal Center Blvd NE', 'Albuquerque', 'Bernalillo', 'NM', '87109', '5052623937', '5052623366', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1376576876', 0, 'N', 0, '2011-10-20', NULL, NULL, 35.1702, -106.586, NULL, NULL),
('204043287', 'ABQ001091', 'ABQ001091', 'NM01', 'ABQ Health Partners', 'Warren', '', 'Rorebeck', 'OD', 'Optometry', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052623937', '5052623366', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052623937', '5052623366', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1376576876', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000691', 'ABQ000691', 'NM01', 'ABQ Health Partners', 'Warren', '', 'Rorebeck', 'OD', 'Optometry', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052623937', '5052623366', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052623937', '5052623366', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1376576876', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000292', 'ABQ000292', 'NM01', 'ABQ Health Partners', 'R. Keith', '', 'Rothberg', 'MD', 'Ophthalmology', '', '', NULL, 'O', '5150 Journal Ctr Blvd NE', 'Albuquerque', 'Bernalillo', 'NM', '87109', '5052623937', '5052623366', '5150 Journal Center Blvd NE', 'Albuquerque', 'Bernalillo', 'NM', '87109', '5052623937', '5052623366', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1164455721', 0, 'N', 0, '2011-10-20', NULL, NULL, 35.1702, -106.586, NULL, NULL),
('204043287', 'ABQ001092', 'ABQ001092', 'NM01', 'ABQ Health Partners', 'R. Keith', '', 'Rothberg', 'MD', 'Ophthalmology', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052623937', '5052623366', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052623937', '5052623366', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1164455721', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000692', 'ABQ000692', 'NM01', 'ABQ Health Partners', 'R. Keith', '', 'Rothberg', 'MD', 'Ophthalmology', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052623937', '5052623366', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052623937', '5052623366', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1164455721', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000293', 'ABQ000293', 'NM01', 'ABQ Health Partners', 'Martin', '', 'Ruiz', 'MD', 'Internal Medicine', '', '', NULL, 'O', '5150 Journal Ctr Blvd NE', 'Albuquerque', 'Bernalillo', 'NM', '87109', '5052623212', '5052623381', '5150 Journal Ctr Blvd NE', 'Albuquerque', 'Bernalillo', 'NM', '87109', '5052623212', '5052623381', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2014-01-24', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1356410104', 0, 'N', 0, '2014-02-05', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ001093', 'ABQ001093', 'NM01', 'ABQ Health Partners', 'Martin', '', 'Ruiz', 'MD', 'Internal Medicine', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052623212', '5052623381', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052623212', '5052623381', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2014-01-24', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1356410104', 0, 'N', 0, '2014-02-05', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000693', 'ABQ000693', 'NM01', 'ABQ Health Partners', 'Martin', '', 'Ruiz', 'MD', 'Internal Medicine', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052623212', '5052623381', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052623212', '5052623381', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2014-01-24', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1356410104', 0, 'N', 0, '2014-02-05', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000294', 'ABQ000294', 'NM01', 'ABQ Health Partners', 'Jessica', '', 'Ryder', 'PA-C', 'Hospitalist', '', '', NULL, 'O', '500 Walter St NE Ste 401', 'Albuquerque', 'Bernalillo', 'NM', '87102', '5057278039', '5057278086', '500 Walter St NE Ste 401', 'Albuquerque', 'Bernalillo', 'NM', '87102', '5057278039', '5057278086', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Medical Center', 'Lovelace Womens Hospital', NULL, NULL, 'HCFA|UB|', '1033371307', 0, 'N', 0, '2014-06-13', NULL, NULL, 35.0863, -106.64, NULL, NULL),
('204043287', 'ABQ001094', 'ABQ001094', 'NM01', 'ABQ Health Partners', 'Jessica', '', 'Ryder', 'PA-C', 'Hospitalist', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5057278039', '5057278086', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5057278039', '5057278086', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Medical Center', 'Lovelace Womens Hospital', NULL, NULL, 'HCFA|UB|', '1033371307', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000694', 'ABQ000694', 'NM01', 'ABQ Health Partners', 'Jessica', '', 'Ryder', 'PA-C', 'Hospitalist', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5057278039', '5057278086', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5057278039', '5057278086', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Medical Center', 'Lovelace Womens Hospital', NULL, NULL, 'HCFA|UB|', '1033371307', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000296', 'ABQ000296', 'NM01', 'ABQ Health Partners', 'Damen', '', 'Sacoman', 'MD', 'Orthopedic Surgery', '', '', NULL, 'O', '10511 Golf Course Rd NW Ste 103', 'Albuquerque', 'Bernalillo', 'NM', '87114', '5053428400', '5053428401', '10511 Golf Course Rd NW Ste 103', 'Albuquerque', 'Bernalillo', 'NM', '87114', '5053428400', '5053428401', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Womens Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1679596977', 0, 'N', 0, '2011-10-20', NULL, NULL, 35.2073, -106.676, NULL, NULL),
('204043287', 'ABQ001095', 'ABQ001095', 'NM01', 'ABQ Health Partners', 'Damen', '', 'Sacoman', 'MD', 'Orthopedic Surgery', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5053428400', '5053428401', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5053428400', '5053428401', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Womens Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1679596977', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000695', 'ABQ000695', 'NM01', 'ABQ Health Partners', 'Damen', '', 'Sacoman', 'MD', 'Orthopedic Surgery', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5053428400', '5053428401', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5053428400', '5053428401', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Womens Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1679596977', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000300', 'ABQ000300', 'NM01', 'ABQ Health Partners', 'Melissa', '', 'Salinas', 'PA-C', 'Urgent Care', '', '', NULL, 'O', '9101 Montgomery Blvd NE', 'Albuquerque', 'Bernalillo', 'NM', '87111', '5052754259', '5052754223', '9101 Montgomery Blvd NE', 'Albuquerque', 'Bernalillo', 'NM', '87111', '5052754259', '5052754223', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2012-02-08', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1619182821', 0, 'Y', 0, '2012-02-16', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ001097', 'ABQ001097', 'NM01', 'ABQ Health Partners', 'Melissa', '', 'Salinas', 'PA-C', 'Urgent Care', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5058968604', '5058968697', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5058968604', '5058968697', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2012-02-08', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1619182821', 0, 'N', 0, '2012-02-16', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000697', 'ABQ000697', 'NM01', 'ABQ Health Partners', 'Melissa', '', 'Salinas', 'PA-C', 'Urgent Care', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5058968604', '5058968697', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5058968604', '5058968697', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2012-02-08', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1619182821', 0, 'N', 0, '2012-02-16', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000301', 'ABQ000301', 'NM01', 'ABQ Health Partners', 'Marianne', '', 'Sanchez', 'CNP', 'Pulmonary', '', '', NULL, 'O', '500 Walter St NE Ste 205', 'Albuquerque', 'Bernalillo', 'NM', '87102', '5052627223', '5052627450', '500 Walter St NE Ste 205', 'Albuquerque', 'Bernalillo', 'NM', '87102', '5052627223', '5052627450', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Medical Center', 'Lovelace Womens Hospital', 'Lovelace Westside Hospital ', NULL, 'HCFA|UB|', '1386948206', 0, 'N', 0, '2011-10-20', NULL, NULL, 35.0863, -106.64, NULL, NULL),
('204043287', 'ABQ001101', 'ABQ001101', 'NM01', 'ABQ Health Partners', 'Marianne', '', 'Sanchez', 'CNP', 'Pulmonary', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052627223', '5052627450', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052627223', '5052627450', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Medical Center', 'Lovelace Womens Hospital', 'Lovelace Westside Hospital ', NULL, 'HCFA|UB|', '1386948206', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000701', 'ABQ000701', 'NM01', 'ABQ Health Partners', 'Marianne', '', 'Sanchez', 'CNP', 'Pulmonary', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052627223', '5052627450', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052627223', '5052627450', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Medical Center', 'Lovelace Womens Hospital', 'Lovelace Westside Hospital ', NULL, 'HCFA|UB|', '1386948206', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ001102', 'ABQ001102', 'NM01', 'ABQ Health Partners', 'Lilibeth', '', 'Sanchez-Geswaldo', 'DO', 'General Surgery', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052627281', '5052627622', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052627281', '5052627622', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Medical Center', 'Lovelace Womens Hospital', 'Lovelace Westside Hospital ', NULL, 'HCFA|UB|', '1710989033', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000302', 'ABQ000302', 'NM01', 'ABQ Health Partners', 'Lilibeth', '', 'Sanchez-Geswaldo', 'DO', 'General Surgery', '', '', NULL, 'O', '715 Dr Martin Luther King Jr Ave NE Ste 301', 'Albuquerque', 'Bernalillo', 'NM', '87102', '5052627281', '5052627622', '715 Dr Martin Luther King Jr Ave NE Ste 301', 'Albuquerque', 'Bernalillo', 'NM', '87102', '5052627281', '5052627622', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Medical Center', 'Lovelace Womens Hospital', 'Lovelace Westside Hospital ', NULL, 'HCFA|UB|', '1710989033', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000702', 'ABQ000702', 'NM01', 'ABQ Health Partners', 'Lilibeth', '', 'Sanchez-Geswaldo', 'DO', 'General Surgery', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052627281', '5052627622', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052627281', '5052627622', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Medical Center', 'Lovelace Womens Hospital', 'Lovelace Westside Hospital ', NULL, 'HCFA|UB|', '1710989033', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000304', 'ABQ000304', 'NM01', 'ABQ Health Partners', 'Vesta', '', 'Sandoval', 'MD', 'Pulmonary', '', '', NULL, 'O', '4801 McMahon Blvd NW Ste 250', 'Albuquerque', 'Bernalillo', 'NM', '87114', '5052321190', '5052322355', '4801 McMahon Blvd NW Ste 250', 'Albuquerque', 'Bernalillo', 'NM', '87114', '5052321190', '5052322355', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2013-01-01', 0, 0, 0, 'Lovelace Medical Center', '', '', '', 'HCFA|UB|', '1376566497', 0, 'N', 0, '2013-10-09', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ001103', 'ABQ001103', 'NM01', 'ABQ Health Partners', 'Vesta', '', 'Sandoval', 'MD', 'Pulmonary', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052321190', '5052322355', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052321190', '5052322355', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2013-01-01', 0, 0, 0, 'Lovelace Medical Center', '', '', '', 'HCFA|UB|', '1376566497', 0, 'N', 0, '2013-10-09', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000703', 'ABQ000703', 'NM01', 'ABQ Health Partners', 'Vesta', '', 'Sandoval', 'MD', 'Pulmonary', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052321190', '5052322355', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052321190', '5052322355', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2013-01-01', 0, 0, 0, 'Lovelace Medical Center', '', '', '', 'HCFA|UB|', '1376566497', 0, 'N', 0, '2013-10-09', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000305', 'ABQ000305', 'NM01', 'ABQ Health Partners', 'Ronald', '', 'Sautter', 'MD', 'Family Practice', '', '', NULL, 'O', '5400 Gibson Blvd SE', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052627110', '5052627829', '5400 Gibson Blvd SE', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052627110', '5052627829', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1376577577', 0, 'N', 0, '2011-10-20', NULL, NULL, 35.0583, -106.582, NULL, NULL),
('204043287', 'ABQ000705', 'ABQ000705', 'NM01', 'ABQ Health Partners', 'Ronald', '', 'Sautter', 'MD', 'Family Practice', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052627110', '5052627829', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052627110', '5052627829', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1376577577', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000306', 'ABQ000306', 'NM01', 'ABQ Health Partners', 'Jeffrey', '', 'Schafter', 'OD', 'Optometry', '', '', NULL, 'O', '5400 Gibson Blvd SE', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052623937', '5052627147', '5400 Gibson Blvd SE', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052623937', '5052627147', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2012-01-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1811922800', 0, 'N', 0, '2012-01-18', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000706', 'ABQ000706', 'NM01', 'ABQ Health Partners', 'Jeffrey', '', 'Schafter', 'OD', 'Optometry', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052623937', '5052627147', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052623937', '5052627147', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2012-01-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1811922800', 0, 'N', 0, '2012-01-18', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000307', 'ABQ000307', 'NM01', 'ABQ Health Partners', 'Carol', '', 'Scott', 'NP', 'Family Practice', '', '', NULL, 'O', '200 Rio Bravo Blvd SE', 'Albuquerque', 'Bernalillo', 'NM', '87105', '5058736400', '5058736403', '200 Rio Bravo Blvd SE', 'Albuquerque', 'Bernalillo', 'NM', '87105', '5058736400', '5058736403', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2012-01-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1417959446', 0, 'N', 0, '2012-01-17', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ001107', 'ABQ001107', 'NM01', 'ABQ Health Partners', 'Carol', '', 'Scott', 'NP', 'Family Practice', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5058736400', '5058736403', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5058736400', '5058736403', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1417959446', 0, 'N', 0, '2012-01-17', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000707', 'ABQ000707', 'NM01', 'ABQ Health Partners', 'Carol', '', 'Scott', 'NP', 'Family Practice', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5058736400', '5058736403', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5058736400', '5058736403', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1417959446', 0, 'N', 0, '2012-01-17', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000308', 'ABQ000308', 'NM01', 'ABQ Health Partners', 'Jorge', '', 'Sedas', 'MD', 'Internal Medicine', '', '', NULL, 'O', '5400 Gibson Blvd SE', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052627110', '5052627829', '5400 Gibson Blvd SE', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052627110', '5052627829', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1710910203', 0, 'N', 0, '2011-10-20', NULL, NULL, 35.0583, -106.582, NULL, NULL),
('204043287', 'ABQ000708', 'ABQ000708', 'NM01', 'ABQ Health Partners', 'Jorge', '', 'Sedas', 'MD', 'Internal Medicine', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052627110', '5052627829', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052627110', '5052627829', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1710910203', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000309', 'ABQ000309', 'NM01', 'ABQ Health Partners', 'Michael', '', 'Seligson', 'MD', 'Ophthalmology', '', '', NULL, 'O', '5400 Gibson Blvd SE', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052623937', '5052627147', '5400 Gibson Blvd SE', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052623937', '5052627147', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2012-02-17', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1124069471', 0, 'N', 0, '2012-03-05', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000709', 'ABQ000709', 'NM01', 'ABQ Health Partners', 'Michael', '', 'Seligson', 'MD', 'Ophthalmology', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052623937', '5052627147', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052623937', '5052627147', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2012-02-17', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1124069471', 0, 'N', 0, '2012-03-05', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000310', 'ABQ000310', 'NM01', 'ABQ Health Partners', 'David', '', 'Shanley', 'MD', 'Family Practice', '', '', NULL, 'O', '10511 Golf Course Rd NW Ste 103', 'Albuquerque', 'Bernalillo', 'NM', '87114', '5052321100', '5052321153', '10511 Golf Course Rd NW Ste 103', 'Albuquerque', 'Bernalillo', 'NM', '87114', '5052321100', '5052321153', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2012-08-17', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1154374965', 0, 'N', 0, '2012-09-07', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ001110', 'ABQ001110', 'NM01', 'ABQ Health Partners', 'David', '', 'Shanley', 'MD', 'Family Practice', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052321100', '5052321153', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052321100', '5052321153', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2012-08-17', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1154374965', 0, 'N', 0, '2012-09-07', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000710', 'ABQ000710', 'NM01', 'ABQ Health Partners', 'David', '', 'Shanley', 'MD', 'Family Practice', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052321100', '5052321153', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052321100', '5052321153', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2012-08-17', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1154374965', 0, 'N', 0, '2012-09-07', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000311', 'ABQ000311', 'NM01', 'ABQ Health Partners', 'Robert', '', 'Shannon', 'MD', 'Internal Medicine', '', '', NULL, 'O', '5400 Gibson Blvd SE', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052627110', '5052627829', '5400 Gibson Blvd SE', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052627110', '5052627829', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2013-03-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1356364467', 0, 'N', 0, '2013-04-30', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000711', 'ABQ000711', 'NM01', 'ABQ Health Partners', 'Robert', '', 'Shannon', 'MD', 'Internal Medicine', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052627110', '5052627829', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052627110', '5052627829', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2013-03-31', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1356364467', 0, 'N', 0, '2013-04-30', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000312', 'ABQ000312', 'NM01', 'ABQ Health Partners', 'Ashish', '', 'Sharma', 'MD', 'Internal Medicine', '', '', NULL, 'O', '5150 Journal Center Blvd NE', 'Albuquerque', 'Bernalillo', 'NM', '87109', '5052623212', '5052623381', '5150 Journal Center Blvd NE', 'Albuquerque', 'Bernalillo', 'NM', '87109', '5052623212', '5052623381', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2012-01-09', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1154394799', 0, 'N', 0, '2012-02-16', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ001112', 'ABQ001112', 'NM01', 'ABQ Health Partners', 'Ashish', '', 'Sharma', 'MD', 'Internal Medicine', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052623212', '5052623381', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052623212', '5052623381', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2012-01-09', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1154394799', 0, 'N', 0, '2012-02-16', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000712', 'ABQ000712', 'NM01', 'ABQ Health Partners', 'Ashish', '', 'Sharma', 'MD', 'Internal Medicine', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052623212', '5052623381', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052623212', '5052623381', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2012-01-09', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1154394799', 0, 'N', 0, '2012-02-16', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000316', 'ABQ000316', 'NM01', 'ABQ Health Partners', 'J.', '', 'Sharp', 'MD', 'Urgent Care', '', '', NULL, 'O', '1721 Rio Rancho Blvd SE', 'Rio Rancho', 'Sandoval', 'NM', '87124', '5058968604', '5058968697', '1721 Rio Rancho Blvd SE', 'Rio Rancho', 'Sandoval', 'NM', '87124', '5058968604', '5058968697', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Womens Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1477576577', 0, 'Y', 0, '2012-01-17', NULL, NULL, 35.2284, -106.66, NULL, NULL),
('204043287', 'ABQ001113', 'ABQ001113', 'NM01', 'ABQ Health Partners', 'J.', '', 'Sharp', 'MD', 'Urgent Care', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5058968604', '5058968697', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5058968604', '5058968697', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Womens Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1477576577', 0, 'Y', 0, '2012-01-17', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000713', 'ABQ000713', 'NM01', 'ABQ Health Partners', 'J.', '', 'Sharp', 'MD', 'Urgent Care', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5058968604', '5058968697', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5058968604', '5058968697', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Womens Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1477576577', 0, 'N', 0, '2012-01-17', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000318', 'ABQ000318', 'NM01', 'ABQ Health Partners', 'Karen', '', 'Shatar', 'CNM', 'Obstetrics and Gynecology', '', '', NULL, 'O', '10511 Golf Course Rd NW Ste 204', 'Albuquerque', 'Bernalillo', 'NM', '87114', '5052546500', '5052546532', '10511 Golf Course Rd NW Ste 204', 'Albuquerque', 'Bernalillo', 'NM', '87114', '5052546500', '5052546532', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2013-09-14', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1780617274', 0, 'N', 0, '2013-09-24', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ001117', 'ABQ001117', 'NM01', 'ABQ Health Partners', 'Karen', '', 'Shatar', 'CNM', 'Obstetrics and Gynecology', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052546500', '5052546532', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052546500', '5052546532', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2013-09-14', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1780617274', 0, 'N', 0, '2013-09-24', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000717', 'ABQ000717', 'NM01', 'ABQ Health Partners', 'Karen', '', 'Shatar', 'CNM', 'Obstetrics and Gynecology', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052546500', '5052546532', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052546500', '5052546532', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2013-09-14', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1780617274', 0, 'N', 0, '2013-09-24', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000319', 'ABQ000319', 'NM01', 'ABQ Health Partners', 'Paul', '', 'Shelburne', 'MD', 'Obstetrics and Gynecology', '', '', NULL, 'O', '4705 Montgomery Blvd NE Ste 301-302', 'Albuquerque', 'Bernalillo', 'NM', '87109', '5052546500', '5052546532', '4705 Montgomery Blvd NE Ste 301-302', 'Albuquerque', 'Bernalillo', 'NM', '87109', '5052546500', '5052546532', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2013-09-03', 0, 0, 0, 'Lovelace Womens Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1134154156', 0, 'N', 0, '2013-09-09', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ001119', 'ABQ001119', 'NM01', 'ABQ Health Partners', 'Paul', '', 'Shelburne', 'MD', 'Obstetrics and Gynecology', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052546500', '5052546532', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052546500', '5052546532', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Womens Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1134154156', 0, 'N', 0, '2013-09-09', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000719', 'ABQ000719', 'NM01', 'ABQ Health Partners', 'Paul', '', 'Shelburne', 'MD', 'Obstetrics and Gynecology', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052546500', '5052546532', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052546500', '5052546532', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Womens Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1134154156', 0, 'N', 0, '2013-09-09', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000320', 'ABQ000320', 'NM01', 'ABQ Health Partners', 'Nina', '', 'Simon', 'CNM', 'Obstetrics and Gynecology', '', '', NULL, 'O', '4701 Montgomery Blvd NE Ste 301-302', 'Albuquerque', 'Bernalillo', 'NM', '87109', '5057277600', '5057277640', '4701 Montgomery Blvd NE Ste 301-302', 'Albuquerque', 'Bernalillo', 'NM', '87109', '5057277600', '5057277640', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2012-01-01', 0, 0, 0, 'Lovelace Womens Hospital', 'Lovelace Westside Hospital', '', '', 'HCFA|UB|', '1811185036', 0, 'N', 0, '2014-06-24', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ001120', 'ABQ001120', 'NM01', 'ABQ Health Partners', 'Nina', '', 'Simon', 'CNM', 'Obstetrics and Gynecology', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5057277600', '5057277640', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5057277600', '5057277640', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Womens Hospital', 'Lovelace Westside Hospital', '', '', 'HCFA|UB|', '1811185036', 0, 'N', 0, '2014-06-24', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000720', 'ABQ000720', 'NM01', 'ABQ Health Partners', 'Nina', '', 'Simon', 'CNM', 'Obstetrics and Gynecology', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5057277600', '5057277640', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5057277600', '5057277640', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Womens Hospital', 'Lovelace Westside Hospital', '', '', 'HCFA|UB|', '1811185036', 0, 'N', 0, '2014-06-24', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000321', 'ABQ000321', 'NM01', 'ABQ Health Partners', 'Janet', '', 'Stebleton', 'CNP', 'Sleep Medicine', '', '', NULL, 'O', '4700 Jefferson St NE Ste 800', 'Albuquerque', 'Bernalillo', 'NM', '87109', '5058726000', '5058726003', '4700 Jefferson St NE Ste 800', 'Albuquerque', 'Bernalillo', 'NM', '87109', '5058726000', '5058726003', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2012-12-04', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1497778658', 0, 'N', 0, '2013-02-14', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ001121', 'ABQ001121', 'NM01', 'ABQ Health Partners', 'Janet', '', 'Stebleton', 'CNP', 'Sleep Medicine', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5058726000', '5058726003', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5058726000', '5058726003', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2012-12-04', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1497778658', 0, 'N', 0, '2013-02-14', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000721', 'ABQ000721', 'NM01', 'ABQ Health Partners', 'Janet', '', 'Stebleton', 'CNP', 'Sleep Medicine', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5058726000', '5058726003', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5058726000', '5058726003', 'NMABQ', 'WUSTDHCPC5', '', '0.00', '40.00', '0.00', 3, '2012-01-01', '2012-12-04', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1497778658', 0, 'N', 0, '2013-02-14', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000322', 'ABQ000322', 'NM01', 'ABQ Health Partners', 'Keith', '', 'Steichen', 'MD', 'Family Practice', '', '', NULL, 'O', '13701 Encantado Rd NE', 'Albuquerque', 'Bernalillo', 'NM', '87123', '5052378700', '5052378703', '13701 Encantado Rd NE', 'Albuquerque', 'Bernalillo', 'NM', '87123', '5052378700', '5052378703', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1750314316', 0, 'N', 0, '2011-10-20', NULL, NULL, 35.0743, -106.497, NULL, NULL),
('204043287', 'ABQ001122', 'ABQ001122', 'NM01', 'ABQ Health Partners', 'Keith', '', 'Steichen', 'MD', 'Family Practice', '', '', NULL, 'M', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052378700', '5052378703', '5400 Gibson Blvd SE ', 'Albuquerque', 'Bernalillo', 'NM', '87108', '5052378700', '5052378703', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1750314316', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL),
('204043287', 'ABQ000722', 'ABQ000722', 'NM01', 'ABQ Health Partners', 'Keith', '', 'Steichen', 'MD', 'Family Practice', '', '', NULL, 'B', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052378700', '5052378703', 'PO Box 27829           ', 'Albuquerque', 'Bernalillo', 'NM', '87125', '5052378700', '5052378703', 'NMABQ', 'WUSTDHCPC5', NULL, '0.00', '40.00', '0.00', 3, '2012-01-01', NULL, 0, 0, 0, 'Lovelace Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1750314316', 0, 'N', 0, '2011-10-20', NULL, NULL, 0, 0, NULL, NULL);
