Active NPI
San Miguel Clinic Corp Dba Northern New Mexico Urology
- Urology Physician
- Las Vegas, NM
National Provider Identifier
1306830450
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Urology Physician
- License
- 2000173
- Legal business name
- SAN MIGUEL CLINIC CORP DBA NORTHERN NEW MEXICO UROLOGY
- Practice address
- 2301 7TH St
Las Vegas, NM 87701-4966 - Phone
- (505) 454-4000
- Fax
- (505) 454-4004
- NPI assigned
- Sep 6, 2005
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Akhil Das, MD
- Title
- Urology
- Phone
- (505) 454-4000
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Urology Physician | 208800000X | 2000173 | NM | Primary |
Addresses
Primary practice location
2301 7TH St
Las Vegas, NM 87701-4966
Mailing address
2301 7TH St
Las Vegas, NM 87701-4966
Phone (505) 454-4000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 09426531 | Medicaid | NM |
National Provider Directory
National Provider Directory- Tax ID family
- LV Medical Group- Family Medicine
Other organizations with this tax ID 2
Organizations that report the same tax identification number in the National Provider Directory.
-
- Rural Health Clinic/Center
- Las Vegas, NM
- NPI 1306233846
-
- Family Medicine Physician
- Las Vegas, NM
- NPI 1790157980
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Urology Physician
- Orange, CA
- NPI 1053310821
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1125964800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1306830450",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2301 7TH ST",
"city": "LAS VEGAS",
"state": "NM",
"postal_code": "877014966",
"telephone_number": "505-454-4000",
"fax_number": "505-454-4004"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2301 7TH ST",
"city": "LAS VEGAS",
"state": "NM",
"postal_code": "877014966",
"telephone_number": "505-454-4000",
"fax_number": "505-454-4004"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SAN MIGUEL CLINIC CORP DBA NORTHERN NEW MEXICO UROLOGY",
"organizational_subpart": "NO",
"enumeration_date": "2005-09-06",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "DAS",
"authorized_official_first_name": "AKHIL",
"authorized_official_title_or_position": "UROLOGY",
"authorized_official_telephone_number": "505-454-4000",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "208800000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Urology",
"state": "NM",
"license": "2000173",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "09426531",
"state": "NM"
}
],
"endpoints": [],
"other_names": []
}Other providers in Las Vegas, 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.