NPIMap

Organization Active NPI

Elizabeth MD Facial Plastic Surgery LLC

  • Facial Plastic Surgery Physician
  • Albuquerque, NM
National Provider Identifier
1609653336
Registry record updated Sep 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Facial Plastic Surgery PhysicianTaxonomy code 207YS0123X
Legal business name
ELIZABETH MD FACIAL PLASTIC SURGERY LLC
Practice address
4100 Wolcott Ave NE Ste a
Albuquerque, NM 87109-4572
Phone
(505) 855-5500
Fax
(505) 855-5501
NPI assigned
Sep 14, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2023

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

Authorized official

Name
Elizabeth Blasberg, MDNPI 1407275829
Title
Physician/Owner
Phone
(505) 855-5500

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Facial Plastic Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207YS0123X Primary

Addresses

Primary practice location

4100 Wolcott Ave NE Ste a
Albuquerque, NM 87109-4572

Mailing address

4100 Wolcott Ave NE Ste a
Albuquerque, NM 87109-4572
Phone (505) 855-5500

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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": "1694649600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694649600000",
    "number": "1609653336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4100 WOLCOTT AVE NE STE A",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871094572",
            "telephone_number": "505-855-5500",
            "fax_number": "505-855-5501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4100 WOLCOTT AVE NE STE A",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871094572",
            "telephone_number": "505-855-5500",
            "fax_number": "505-855-5501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELIZABETH MD FACIAL PLASTIC SURGERY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-14",
        "last_updated": "2023-09-14",
        "certification_date": "2023-09-14",
        "status": "A",
        "authorized_official_last_name": "BLASBERG",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_title_or_position": "PHYSICIAN/OWNER",
        "authorized_official_telephone_number": "505-855-5500",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207YS0123X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Otolaryngology, Facial Plastic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Sep 14, 2023; 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.