Albuquerque Urology Associates, PA

Primary specialty

Urology PhysicianTaxonomy code 208800000X

Legal business name

ALBUQUERQUE UROLOGY ASSOCIATES, PA

Practice address

610 Broadway Blvd NE
Albuquerque, NM 87102-2372

Phone

(505) 242-3991

Fax

(505) 243-8405

NPI assigned

Jul 15, 2006

Organization subpart

No

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

Authorized official

Name

Jonathan Edward Lackner, M.D.

Title

Partner / M.D.

Phone

(505) 242-3991

Specialties & licenses 2

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1152921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1375228800000",
    "number": "1376569921",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "610 BROADWAY BLVD NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871022372",
            "telephone_number": "505-242-3991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 BROADWAY BLVD NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871022372",
            "telephone_number": "505-242-3991",
            "fax_number": "505-243-8405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALBUQUERQUE UROLOGY ASSOCIATES, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-15",
        "last_updated": "2013-07-31",
        "status": "A",
        "authorized_official_last_name": "LACKNER",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_middle_name": "EDWARD",
        "authorized_official_title_or_position": "PARTNER / M.D.",
        "authorized_official_telephone_number": "505-242-3991",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Urology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NM",
            "license": "6682460001",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "44361",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CS1373",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Urology Physician in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Urology Physician in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2013; 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.