NPIMap

Organization Active NPI

Surgical Oncology and Gastrointestinal Surgery Consultants, LLC

  • Surgery Physician
  • Albuquerque, NM
National Provider Identifier
1477095966
Registry record updated Nov 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
2001214 Issued in NM
Legal business name
SURGICAL ONCOLOGY AND GASTROINTESTINAL SURGERY CONSULTANTS, LLC
Practice address
6100 Uptown Blvd NE
Ste 600
Albuquerque, NM 87110-4163
Phone
(505) 200-3808
Fax
(505) 200-3807
NPI assigned
Nov 15, 2016
Organization subpart
Yes
Parent organization
SURGIVAL ONCOLOGY AND GASTROINTESTINAL SURGERY CONSULTANTS, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 15, 2016

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

Authorized official

Name
Monica Lipiz-Vallejos
Title
Clinical Administrative Director
Phone
(505) 200-3808

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered DietitianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 133V00000X LD0825 NM
Surgery PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 208600000X 2001214 NM Primary

Addresses

Primary practice location

6100 Uptown Blvd NE
Ste 600
Albuquerque, NM 87110-4163

Mailing address

6100 Uptown Blvd NE
Ste 600
Albuquerque, NM 87110-4163
Phone (505) 200-3808

Other identifiers 1

IdentifierTypeStateIssuer
10626751MedicaidNM

Other names 1

  • Albuquerque Uptown Doctors HealthCare Center Other name

National Provider Directory

National Provider Directory
Part of
Surgical Oncology Gastroin

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": "1479168000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1479168000000",
    "number": "1477095966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6100 UPTOWN BLVD NE",
            "address_2": "STE 600",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871104163",
            "telephone_number": "505-200-3808",
            "fax_number": "505-200-3807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6100 UPTOWN BLVD NE",
            "address_2": "STE 600",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871104163",
            "telephone_number": "505-200-3808",
            "fax_number": "505-200-3807"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SURGICAL ONCOLOGY AND GASTROINTESTINAL SURGERY CONSULTANTS, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SURGIVAL ONCOLOGY AND GASTROINTESTINAL SURGERY CONSULTANTS, LLC",
        "enumeration_date": "2016-11-15",
        "last_updated": "2016-11-15",
        "status": "A",
        "authorized_official_last_name": "LIPIZ-VALLEJOS",
        "authorized_official_first_name": "MONICA",
        "authorized_official_title_or_position": "CLINICAL ADMINISTRATIVE DIRECTOR",
        "authorized_official_telephone_number": "505-200-3808"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dietitian, Registered",
            "state": "NM",
            "license": "LD0825",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Surgery",
            "state": "NM",
            "license": "2001214",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10626751",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Albuquerque Uptown Doctors HealthCare Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Albuquerque, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2016; 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.