NPIMap

Organization Active NPI

Nephrophiles LLC

  • Nephrology Physician
  • Santa Fe, NM
National Provider Identifier
1124133129
Registry record updated Feb 22, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
Legal business name
NEPHROPHILES LLC
Practice address
2904 Rodeo Park Dr E
Suite 300B
Santa Fe, NM 87505-6305
Phone
(505) 216-3466
Fax
(505) 216-3105
NPI assigned
Aug 20, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2017

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

Authorized official

Name
Charnes Sy Chiu, MDNPI 1548290869
Title
Authorized Official
Phone
(505) 216-3466

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RN0300X Primary

Addresses

Primary practice location

2904 Rodeo Park Dr E
Suite 300B
Santa Fe, NM 87505-6305

Mailing address

2904 Rodeo Park Dr E
Suite 300B
Santa Fe, NM 87505-6305
Phone (505) 216-3466

Other identifiers 1

IdentifierTypeStateIssuer
45039MedicaidNM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070720000748 NM Part B Supplier - Clinic/Group Practice 4284735234 Receives reassigned benefits from 6 practitioners
Practice locations: Santa Fe, NM

National Provider Directory

National Provider Directory
Tax ID family
Nephrophiles2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2904 Rodeo Park Dr E
Ste A1
Santa Fe, NM 87505

2904 Rodeo Park Dr E
Santa Fe, NM 87505
Phone (505) 216-3466

Practitioners & affiliated clinicians

Practitioners 6

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": "1156032000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1487721600000",
    "number": "1124133129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2904 RODEO PARK DR E",
            "address_2": "SUITE 300B",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875056305",
            "telephone_number": "505-216-3466",
            "fax_number": "505-216-3105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2904 RODEO PARK DR E",
            "address_2": "SUITE 300B",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875056305",
            "telephone_number": "505-216-3466",
            "fax_number": "505-216-3105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEPHROPHILES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-20",
        "last_updated": "2017-02-22",
        "status": "A",
        "authorized_official_last_name": "CHIU",
        "authorized_official_first_name": "CHARNES",
        "authorized_official_middle_name": "SY",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "505-216-3466",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "45039",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Fe, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.