Individual provider Active NPI

Petar Turcinovic, MD

  • Surgery Physician
  • Shenandoah, TX
National Provider Identifier
1063404689
Registry record updated Dec 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
MD2021-0724 Issued in NM
Practice address
9200 Pinecroft Dr
Suite 250
Shenandoah, TX 77380-3279
Phone
(281) 419-8400
Fax
(281) 292-1972
NPI assigned
Aug 19, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X MD2021-0724 NM Primary
Surgery Physician 208600000X L4369 TX

Addresses

Primary practice location

9200 Pinecroft Dr
Suite 250
Shenandoah, TX 77380-3279

Mailing address

2559 Medical Dr
Ste 3200
Alamogordo, NM 88310-8703
Phone (281) 419-8400

Other identifiers 1

IdentifierTypeStateIssuer
P000947D3MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, NM2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20060307000096 TX Practitioner - General Surgery 5597771170
I20211223000796 NM Practitioner - General Surgery 5597771170 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Baylor College of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Otero County Hospital AssociationGroup PAC ID 3173516606, 245 clinicians

Practice addresses (Care Compare)

2669 Scenic Dr
Alamogordo, NM 88310-8700
Phone (505) 439-6100

Hospital & facility affiliations

  • Christus Southern New Mexico Hospital, Alamogordo, NM, CCN 320004

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy14
Hernia repair - groin (open)1-10
Upper gastrointestinal (GI) endoscopy for acid reflux24
Melanoma (skin cancer) excision1-10
Removal of tissue1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD2021-0724NMMDSurgery Physician
L4369TXMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Otero County Hospital Association CurrentSince Dec 1, 2021 Accepting new patients
Otero County Hospital Association CurrentSince Dec 1, 2021 Accepting new patients

Locations

2559 Medical Dr
Ste 3200
Alamogordo, NM 88310
Phone (575) 446-5365

2669 Scenic Dr
Alamogordo, NM 88310
Phone (505) 439-6100

Interoperability endpoints

  • Direct secure messaging: petar.turcinovic.1@6965.direct.athenahealth.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1124409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639958400000",
    "number": "1063404689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2559 MEDICAL DR",
            "address_2": "STE 3200",
            "city": "ALAMOGORDO",
            "state": "NM",
            "postal_code": "883108703",
            "telephone_number": "281-419-8400",
            "fax_number": "281-292-1972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9200 PINECROFT DR",
            "address_2": "SUITE 250",
            "city": "SHENANDOAH",
            "state": "TX",
            "postal_code": "773803279",
            "telephone_number": "281-419-8400",
            "fax_number": "281-292-1972"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TURCINOVIC",
        "first_name": "PETAR",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-19",
        "last_updated": "2021-12-20",
        "certification_date": "2021-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NM",
            "license": "MD2021-0724",
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "TX",
            "license": "L4369",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "P000947D3",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Shenandoah, TX

Sources for this page

Verify at the official NPI Registry.