NPIMap

Organization Active NPI

Las Cruces Surgical Associates PA

  • Surgery Physician
  • Las Cruces, NM
National Provider Identifier
1669520987
Registry record updated May 1, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
2004-0619 Issued in NM
Legal business name
LAS CRUCES SURGICAL ASSOCIATES PA
Practice address
2803 Doral CT
Las Cruces, NM 88011-8616
Phone
(505) 522-1931
Fax
(505) 532-1665
NPI assigned
Jan 5, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 1, 2009

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

Authorized official

Name
Kamran Kamali, MD
Title
Owner
Phone
(505) 522-1931

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208600000X 2004-0619 NM Primary

Addresses

Primary practice location

2803 Doral CT
Las Cruces, NM 88011-8616

Mailing address

PO Box 16544
Las Cruces, NM 88004-6544
Phone (505) 522-1931

Other identifiers 1

IdentifierTypeStateIssuer
23051531MedicaidNM

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1167955200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1241136000000",
    "number": "1669520987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 16544",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880046544",
            "telephone_number": "505-522-1931",
            "fax_number": "505-532-1665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2803 DORAL CT",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880118616",
            "telephone_number": "505-522-1931",
            "fax_number": "505-532-1665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAS CRUCES SURGICAL ASSOCIATES PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-05",
        "last_updated": "2009-05-01",
        "status": "A",
        "authorized_official_last_name": "KAMALI",
        "authorized_official_first_name": "KAMRAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "505-522-1931",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "NM",
            "license": "2004-0619",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "23051531",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Cruces, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2009; 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.