Physicians Plaza Surgery Center, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

3233 Issued in NM

Legal business name

PHYSICIANS PLAZA SURGERY CENTER, LLC

Practice address

1631 Hospital Dr Ste 100
Santa Fe, NM 87505-4728

Phone

(505) 955-8420

Fax

(505) 955-8421

NPI assigned

Nov 15, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Paul S Fullerton, D.O.

Title

President

Phone

(505) 955-8420

Specialties & licenses 1

Addresses

Other identifiers 1

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• St. Vincent Hospital

  • Pediatrics Physician
  • Santa Fe, NM
  • NPI 1669597258

  Member Of

  NPD member

Practitioners 1

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

• Steven Craig Robeson, M.D.

  • Urology Physician
  • Santa Fe, NM
  • NPI 1275602617
  NPD (past)

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

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212364800000",
    "number": "1619040268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1631 HOSPITAL DR STE 100",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875054728",
            "telephone_number": "505-955-8420",
            "fax_number": "505-955-8421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1631 HOSPITAL DR STE 100",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875054728",
            "telephone_number": "505-955-8420",
            "fax_number": "505-955-8421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICIANS PLAZA SURGERY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-15",
        "last_updated": "2008-06-02",
        "status": "A",
        "authorized_official_last_name": "FULLERTON",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "505-955-8420",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "NM",
            "license": "3233",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "43937870",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Janet M. Phillips, RN
• Nancy Phillips, DN
• William Cliff Phillips, HAD
• Phyllis Nadine Gonzales
• Physicians Medical Center of Santa Fe, LLC
• Physiotherapy New Mexico LLC
• Maira Pichardo
• Clarice K Pick, D.D.S.
• Melissa Pickett, MA LPCC
• Pieces Family Services LLC

• Ambulatory Surgical Clinic/Center in Santa Fe, NM
• Providers in Santa Fe, NM by specialty
• Ambulatory Surgical Clinic/Center in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 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.