Bruce A Andersen, DPM

Primary specialty

PodiatristTaxonomy code 213E00000X

License

163 Issued in NM

Practice address

109 Railroad Ave
Las Vegas, NM 87701

Phone

(505) 425-9491

Fax

(505) 454-8171

NPI assigned

Oct 3, 2006

Last updated

May 7, 2008By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NM

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Podiatry

Education

New York College of Podiatric Medicine, 1981

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

State of New MexicoGroup PAC ID 2062412869, 21 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• State of New Mexico

  dba NM Behavioral Health Institute at Las Vegas

  • Nursing Facility/Intermediate Care Facility
  • Las Vegas, NM
  • NPI 1992867998
  Medicare reassignment Care Compare group
• Las Vegas Foot Specialist, Inc

  • Podiatrist
  • Las Vegas, NM
  • NPI 1184632929
  Authorized official Same address or phone
• State of New Mexico

  dba New Mexico Behavioral Health Institue at Las Vegas

  • Clinical Medical Laboratory
  • Las Vegas, NM
  • NPI 1407057607
  NPD

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210118400000",
    "number": "1609960699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 RAILROAD AVE",
            "city": "LAS VEGAS",
            "state": "NM",
            "postal_code": "87701",
            "telephone_number": "505-425-9491",
            "fax_number": "505-454-8171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 RAILROAD AVE",
            "city": "LAS VEGAS",
            "state": "NM",
            "postal_code": "87701",
            "telephone_number": "505-425-9491",
            "fax_number": "505-454-8171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSEN",
        "first_name": "BRUCE",
        "middle_name": "A",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2008-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NM",
            "license": "163",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "005351",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRESBYTERIAN HP",
            "identifier": "10478",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Eloy E Aragon Sr., RPH

• Podiatrist in Las Vegas, NM
• Providers in Las Vegas, NM by specialty
• Podiatrist in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.