Organization Active NPI

Robert C Kolosseus MD PC

  • Urology Physician
  • Las Cruces, NM
National Provider Identifier
1013951722
Registry record updated Feb 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
Legal business name
ROBERT C KOLOSSEUS MD PC
Practice address
755 S Telshor Blvd
Ste. 102R
Las Cruces, NM 88011-4688
Phone
(505) 522-5666
Fax
(505) 522-5680
NPI assigned
Jun 15, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2008

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

Authorized official

Name
Veronica Sandoval
Title
Office Manager
Phone
(505) 522-5666

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208800000X Primary

Addresses

Primary practice location

755 S Telshor Blvd
Ste. 102R
Las Cruces, NM 88011-4688

Mailing address

755 S Telshor Blvd
Ste. 102R
Las Cruces, NM 88011-4688
Phone (505) 522-5666

Other identifiers 1

IdentifierTypeStateIssuer
77444MedicaidNM

National Provider Directory

National Provider Directory

Locations

755 S Telshor Blvd
Ste 102R
Las Cruces, NM 88011
Phone (505) 522-5666

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1150329600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1203379200000",
    "number": "1013951722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "755 S TELSHOR BLVD",
            "address_2": "STE. 102R",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880114688",
            "telephone_number": "505-522-5666",
            "fax_number": "505-522-5680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "755 S TELSHOR BLVD",
            "address_2": "STE. 102R",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880114688",
            "telephone_number": "505-522-5666",
            "fax_number": "505-522-5680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERT C KOLOSSEUS MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-15",
        "last_updated": "2008-02-19",
        "status": "A",
        "authorized_official_last_name": "SANDOVAL",
        "authorized_official_first_name": "VERONICA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "505-522-5666"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Urology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "77444",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Cruces, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.