NPIMap

Organization Active NPI

Laser Surgery Holding Company, LTD

  • Interventional Cardiology Physician
  • Phoenix, AZ
National Provider Identifier
1295592731
Registry record updated Mar 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
Legal business name
LASER SURGERY HOLDING COMPANY, LTD
Practice address
2226 W Northern Ave Ste C212
Phoenix, AZ 85021-4929
Phone
(480) 444-7491
NPI assigned
Mar 1, 2024
Last updated
Mar 1, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
LASER SURGERY HOLDING COMPANY, LTDAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 1, 2024

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

Authorized official

Name
Velina Ruelas
Title
Adminstrator
Phone
(480) 444-7491

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X NU
Interventional Cardiology Physician 207RI0011X NU Primary
Ophthalmology Physician 207W00000X NU
Surgery Physician 208600000X NU
Colon & Rectal Surgery Physician 208C00000X NU
Interventional Pain Medicine Physician 208VP0014X NU
Foot & Ankle Surgery Podiatrist 213ES0103X NU

Addresses

Primary practice location

2226 W Northern Ave Ste C212
Phoenix, AZ 85021-4929

Mailing address

2228 W Northern Ave Ste B210
Phoenix, AZ 85021-9336
Phone (480) 444-7491

Other names 1

  • Your Doc Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240416001556 AZ Part B Supplier - Clinic/Group Practice 8628126950 Receives reassigned benefits from 5 practitioners
Practice locations: Phoenix, AZ

Other NPIs with the same Medicare PAC ID 4

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

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
03D2320256Your Doc2226 W Northern Ave Ste C212, Phoenix, AZ 85021Certificate of waiverMar 13, 2027

National Provider Directory

National Provider Directory
Tax ID family
Laser Surgery Holding Company LTD4 organizations share this tax ID, including this one
Part of
Laser Surgery Holding Company LTD

Other organizations with this tax ID 3

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

Locations

2226 W Northern Ave
Ste C212
Phoenix, AZ 85021
Phone (480) 444-7472

Practitioners & affiliated clinicians

Practitioners 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1709251200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709251200000",
    "number": "1295592731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2228 W NORTHERN AVE STE B210",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850219336",
            "telephone_number": "480-444-7491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2226 W NORTHERN AVE STE C212",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850214929",
            "telephone_number": "480-444-7491"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LASER SURGERY HOLDING COMPANY, LTD",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LASER SURGERY HOLDING COMPANY, LTD",
        "enumeration_date": "2024-03-01",
        "last_updated": "2024-03-01",
        "certification_date": "2024-03-01",
        "status": "A",
        "authorized_official_last_name": "RUELAS",
        "authorized_official_first_name": "VELINA",
        "authorized_official_title_or_position": "ADMINSTRATOR",
        "authorized_official_telephone_number": "480-444-7491"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208C00000X",
            "taxonomy_group": "",
            "desc": "Colon & Rectal Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Your Doc",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2024; 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.