Proffer Surgical Associates, LLP

Primary specialty

MOHS-Micrographic Surgery PhysicianTaxonomy code 207ND0101X

License

K6910 Issued in TX

Legal business name

PROFFER SURGICAL ASSOCIATES, LLP

Practice address

1611 Wallace Blvd
Amarillo, TX 79106-1799

Phone

(806) 354-4900

Fax

(806) 352-4987

NPI assigned

Jul 19, 2006

Last updated

Jul 23, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Liana ProfferNPI 1891770046

Title

Physician

Phone

(806) 354-4900

Specialties & licenses 3

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/AGBCAA

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Proffer Surgical Center, PLLC

  • Ambulatory Surgical Clinic/Center
  • Amarillo, TX
  • NPI 1164986683
  NPPES parent name

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Liana H Proffer, MD

  • MOHS-Micrographic Surgery Physician
  • Amarillo, TX
  • NPI 1891770046
  Medicare reassignment Care Compare group NPD Authorized official
• Chelsey Barrett, FNP

  • Family Medicine Physician
  • Amarillo, TX
  • NPI 1205501418
  Medicare reassignment Care Compare group NPD
• Summer Clark, M.D.

  • MOHS-Micrographic Surgery Physician
  • Amarillo, TX
  • NPI 1154736643
  Medicare reassignment Care Compare group NPD
• Patrick Jonathan Proffer, M.D.

  • Plastic and Reconstructive Surgery Physician
  • Amarillo, TX
  • NPI 1952399206
  Medicare reassignment Care Compare group NPD
• Paul L Proffer, M.D.

  • Ophthalmology Physician
  • Amarillo, TX
  • NPI 1962488676
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1374537600000",
    "number": "1164441333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1611 WALLACE BLVD",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791061799",
            "telephone_number": "806-354-4900",
            "fax_number": "806-352-4987"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1611 WALLACE BLVD",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791061799",
            "telephone_number": "806-354-4900",
            "fax_number": "806-352-4987"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFFER SURGICAL ASSOCIATES, LLP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-19",
        "last_updated": "2013-07-23",
        "status": "A",
        "authorized_official_last_name": "PROFFER",
        "authorized_official_first_name": "LIANA",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "806-354-4900"
    },
    "taxonomies": [
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "TX",
            "license": "K6910",
            "primary": true
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "TX",
            "license": "K3932",
            "primary": false
        },
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "TX",
            "license": "M0532",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "187148501",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "0021NJ",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Pro Med Pharmacies Inc
• Pro Med Pharmacies, Inc. (Pro Med LTC)
• Professional Case Management of Texas
• Professional Physical Therapy Services LLC (Advanced Health Systems)
• Professional Solutions
• Proffer Surgical Center, PLLC
• Liana H Proffer, MD
• Patrick Jonathan Proffer, M.D.
• Paul L Proffer, M.D.
• Progressive Step Corp (Progressive Step Rehabilitation Services)

• MOHS-Micrographic Surgery Physician in Amarillo, TX
• Providers in Amarillo, TX by specialty
• MOHS-Micrographic Surgery Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.