NPIMap

Organization Active NPI

Lisa B. Partyka, PH.D. LLC

  • Clinic/Center
  • Las Cruces, NM
National Provider Identifier
1417279233
Registry record updated Feb 20, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
03176603000 Issued in NM
Legal business name
LISA B. PARTYKA, PH.D. LLC
Practice address
4314 Tewa CT
Las Cruces, NM 88011-4348
Phone
(575) 647-8040
NPI assigned
Feb 20, 2010
Last updated
Feb 20, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2010

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

Authorized official

Name
Dr. Lisa B. Partyka, PH.D.
Title
Clinical Psychologist
Phone
(575) 647-8040

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X 03176603000 NM Primary

Addresses

Primary practice location

4314 Tewa CT
Las Cruces, NM 88011-4348

Mailing address

2145 El Paseo Rd
Las Cruces, NM 88001-6008
Phone (575) 647-8040

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100224000978 NM Part B Supplier - Clinic/Group Practice 7416091715 Receives reassigned benefits from 1 practitioner
Practice locations: Las Cruces, NM

National Provider Directory

National Provider Directory

Locations

2145 El Paseo Rd
Las Cruces, NM 88001
Phone (575) 635-9653

Practitioners & affiliated clinicians

Practitioners 4

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": "1266624000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1266624000000",
    "number": "1417279233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2145 EL PASEO RD",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880016008",
            "telephone_number": "575-647-8040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4314 TEWA CT",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880114348",
            "telephone_number": "575-647-8040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LISA B. PARTYKA, PH.D. LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-02-20",
        "last_updated": "2010-02-20",
        "status": "A",
        "authorized_official_last_name": "PARTYKA",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "B.",
        "authorized_official_title_or_position": "CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "575-647-8040",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NM",
            "license": "03176603000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Cruces, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2010; 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.