Organization Active NPI

Allan L. Paul M.D., PC

  • Pediatric Adolescent Medicine Physician
  • Alamogordo, NM
National Provider Identifier
1124233903
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X
License
8857 Issued in NM
Legal business name
ALLAN L. PAUL M.D., PC
Practice address
2559 Medical Dr
Ste E
Alamogordo, NM 88310-8703
Phone
(505) 437-5595
Fax
(505) 437-1330
NPI assigned
May 14, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Allan Lewis Paul, M.D.
Title
President
Phone
(505) 437-5595

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Adolescent Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2080A0000X 8857 NM Primary

Addresses

Primary practice location

2559 Medical Dr
Ste E
Alamogordo, NM 88310-8703

Mailing address

2559 Medical Dr
Ste E
Alamogordo, NM 88310-8703
Phone (505) 437-5595

Other identifiers 5

IdentifierTypeStateIssuer
79488285MedicaidNM
A002OtherNMTRICARE
10003502OtherNMLOVELACE SALUD
QMYPR0072232OtherNJMOLINA HEALTHCARE
NM012112OtherNMBC BS

National Provider Directory

National Provider Directory

Locations

2559 Medical Dr
Ste E
Alamogordo, NM 88310
Phone (505) 437-5595

Practitioners 1

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": "1179100800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1124233903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2559 MEDICAL DR",
            "address_2": "STE E",
            "city": "ALAMOGORDO",
            "state": "NM",
            "postal_code": "883108703",
            "telephone_number": "505-437-5595",
            "fax_number": "505-437-1330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2559 MEDICAL DR",
            "address_2": "STE E",
            "city": "ALAMOGORDO",
            "state": "NM",
            "postal_code": "883108703",
            "telephone_number": "505-437-5595",
            "fax_number": "505-437-1330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALLAN L. PAUL M.D., PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-14",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PAUL",
        "authorized_official_first_name": "ALLAN",
        "authorized_official_middle_name": "LEWIS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "505-437-5595",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "NM",
            "license": "8857",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "79488285",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "A002",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LOVELACE SALUD",
            "identifier": "10003502",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MOLINA HEALTHCARE",
            "identifier": "QMYPR0072232",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC BS",
            "identifier": "NM012112",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Alamogordo, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.