NPIMap

Organization Active NPI

Galveston Dermatology, P.a.

  • Dermatology Physician
  • Taos, NM
National Provider Identifier
1154586147
Registry record updated Jul 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
MD2006-0560 Issued in NM
Legal business name
GALVESTON DERMATOLOGY, P.A.
Practice address
1399 Weimer Rd
Suite 200
Taos, NM 87571-6340
Phone
(575) 779-0361
Fax
(409) 763-2458
NPI assigned
Jul 19, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2008

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

Authorized official

Name
Dr. Ramon L Sanchez, M.D.NPI 1366556193
Title
President
Phone
(409) 763-2452

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207N00000X MD2006-0560 NM Primary
Dermatopathology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207ND0900X MD2006-0560 NM

Addresses

Primary practice location

1399 Weimer Rd
Suite 200
Taos, NM 87571-6340

Mailing address

1501 Broadway St
Galveston, TX 77550-4906
Phone (409) 763-2452

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20081106000071 NM Part B Supplier - Clinic/Group Practice 2163464843 Receives reassigned benefits from 1 practitioner
Practice locations: Taos, NM

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Galveston Dermatology2 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.

Practitioners & affiliated clinicians

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": "1216425600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216425600000",
    "number": "1154586147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 BROADWAY ST",
            "city": "GALVESTON",
            "state": "TX",
            "postal_code": "775504906",
            "telephone_number": "409-763-2452",
            "fax_number": "409-763-2458"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1399 WEIMER RD",
            "address_2": "SUITE 200",
            "city": "TAOS",
            "state": "NM",
            "postal_code": "875716340",
            "telephone_number": "575-779-0361",
            "fax_number": "409-763-2458"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GALVESTON DERMATOLOGY, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-19",
        "last_updated": "2008-07-19",
        "status": "A",
        "authorized_official_last_name": "SANCHEZ",
        "authorized_official_first_name": "RAMON",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "409-763-2452",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": "NM",
            "license": "MD2006-0560",
            "primary": true
        },
        {
            "code": "207ND0900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology, Dermatopathology",
            "state": "NM",
            "license": "MD2006-0560",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Taos, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2008; 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.