Prostate Cancer Institute of New Mexico PC

Primary specialty

Radiation Oncology PhysicianTaxonomy code 2085R0001X

Legal business name

PROSTATE CANCER INSTITUTE OF NEW MEXICO PC

Practice address

2300 E 30TH St Ste B-106
Farmington, NM 87401-8991

Phone

(505) 421-3144

Fax

(505) 421-3145

NPI assigned

Mar 21, 2024

Organization subpart

No

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

Authorized official

Name

Ajay Bhatnagar, MD

Title

Owner and Physician

Phone

(520) 360-2895

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1710979200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1723680000000",
    "number": "1619737079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 15088",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850605088",
            "telephone_number": "505-421-3144",
            "fax_number": "505-421-3145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 E 30TH ST STE B-106",
            "city": "FARMINGTON",
            "state": "NM",
            "postal_code": "874018991",
            "telephone_number": "505-421-3144",
            "fax_number": "505-421-3145"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "801 W Maple St",
            "address_purpose": "LOCATION",
            "city": "Farmington",
            "state": "NM",
            "postal_code": "874015630",
            "country_code": "US",
            "telephone_number": "505-421-3144",
            "fax_number": "505-421-3145",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PROSTATE CANCER INSTITUTE OF NEW MEXICO PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-21",
        "last_updated": "2024-08-15",
        "certification_date": "2024-08-15",
        "status": "A",
        "authorized_official_last_name": "BHATNAGAR",
        "authorized_official_first_name": "AJAY",
        "authorized_official_title_or_position": "OWNER AND PHYSICIAN",
        "authorized_official_telephone_number": "520-360-2895",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Radiation Oncology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Radiation Oncology Physician in Farmington, NM
• Providers in Farmington, NM by specialty
• Radiation Oncology Physician in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2024; 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.