Active NPI
Marc Flitter, M.D.
- Surgery Physician
- Farmington, NM
National Provider Identifier
1649203266
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 2001-190
- Practice address
- 407 S Schwartz Ave
Suite 202
Farmington, NM 87401-5925 - Phone
- (505) 609-6580
- Fax
- (505) 609-6579
- NPI assigned
- Jul 8, 2006
- Last updated
- May 1, 2013
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 2001-190 | NM | Primary |
Addresses
Primary practice location
407 S Schwartz Ave
Suite 202
Farmington, NM 87401-5925
Mailing address
PO Box 6210
Farmington, NM 87499-6210
Phone (505) 609-2258
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000B0165 | Medicaid | NM |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2001-190 | NM | MD | Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152316800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1367366400000",
"number": "1649203266",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 6210",
"city": "FARMINGTON",
"state": "NM",
"postal_code": "874996210",
"telephone_number": "505-609-2258",
"fax_number": "505-609-2259"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "407 S SCHWARTZ AVE",
"address_2": "SUITE 202",
"city": "FARMINGTON",
"state": "NM",
"postal_code": "874015925",
"telephone_number": "505-609-6580",
"fax_number": "505-609-6579"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FLITTER",
"first_name": "MARC",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-08",
"last_updated": "2013-05-01",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "NM",
"license": "2001-190",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000B0165",
"state": "NM"
}
],
"endpoints": [],
"other_names": []
}Other providers in Farmington, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.