Theodore Potruch, MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

Legal business name

THEODORE POTRUCH, MD

Doing business as

BreastCare

Practice address

2020 Goldring Ave
#206
Las Vegas, NV 89106-4000

Phone

(702) 382-2273

Fax

(702) 385-9956

NPI assigned

Feb 7, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Theodore Potruch, MD

Title

Director

Phone

(702) 382-2273

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• BreastCare Doing business as

Locations

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

{
    "created_epoch": "1170806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1200355200000",
    "number": "1447390646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2020 GOLDRING AVE",
            "address_2": "#206",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891064000",
            "telephone_number": "702-382-2273",
            "fax_number": "702-385-9956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2020 GOLDRING AVE",
            "address_2": "#206",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891064000",
            "telephone_number": "702-382-2273",
            "fax_number": "702-385-9956"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THEODORE POTRUCH, MD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-07",
        "last_updated": "2008-01-15",
        "status": "A",
        "authorized_official_last_name": "POTRUCH",
        "authorized_official_first_name": "THEODORE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "702-382-2273",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0022702550",
            "state": "NV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "NV2969",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BreastCare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Thema Hospice, Inc.
• Geormesha Lache Thenarse
• Briana Nicole Theocharides
• Theodore M. Thorp M.D., Prof Corp.
• Theodore Potruch MD LTD a Professional Corporation
• Scherley Theodore
• Raymond Barrier Theodosis, M.D.
• Dianna Lynn Theokas, AU.D.
• Theracounsel NV, Inc.
• Theranation LLC

• Surgery Physician in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Surgery Physician in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2008; 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.