Organization Active NPI

Andrew J Conlu MD PLLC

  • Hospitalist Physician
  • Winnemucca, NV
National Provider Identifier
1427480102
Registry record updated Aug 5, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
6600 Issued in NV
Legal business name
ANDREW J CONLU MD PLLC
Practice address
118 E Haskell St
Winnemucca, NV 89445-3247
Phone
(775) 623-5222
NPI assigned
Aug 5, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2013

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

Authorized official

Name
Lori Labrecque
Title
Accts MGR
Phone
(702) 453-3799

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X 6600 NV
Hospitalist PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208M00000X 6600 NV Primary

Addresses

Primary practice location

118 E Haskell St
Winnemucca, NV 89445-3247

Mailing address

PO Box 230545
Las Vegas, NV 89105-0545
Phone (702) 453-3799

Other identifiers 1

IdentifierTypeStateIssuer
6600OtherNVNV LICENSE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140423001913 OR Part B Supplier - Clinic/Group Practice 8820225790 Receives reassigned benefits from 1 practitioner
Practice locations: Gold Beach, OR

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1375660800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1375660800000",
    "number": "1427480102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 230545",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891050545",
            "telephone_number": "702-453-3799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "118 E HASKELL ST",
            "city": "WINNEMUCCA",
            "state": "NV",
            "postal_code": "894453247",
            "telephone_number": "775-623-5222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANDREW J CONLU MD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-08-05",
        "last_updated": "2013-08-05",
        "status": "A",
        "authorized_official_last_name": "LABRECQUE",
        "authorized_official_first_name": "LORI",
        "authorized_official_title_or_position": "ACCTS MGR",
        "authorized_official_telephone_number": "702-453-3799"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "NV",
            "license": "6600",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Hospitalist",
            "state": "NV",
            "license": "6600",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NV LICENSE",
            "identifier": "6600",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winnemucca, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2013; 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.