Summit Specialty Physicians Inc

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

Legal business name

SUMMIT SPECIALTY PHYSICIANS INC

Practice address

653 N Town Center Dr Ste 506
Las Vegas, NV 89144-0519

Phone

(617) 895-7644

NPI assigned

May 6, 2022

Organization subpart

No

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

Authorized official

Name

Amy Carolyn JosephNPI 1376557058

Title

Ceo

Phone

(203) 913-0661

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NV

Enrollment records 1

Practitioners 3

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

• Saju Joseph, MD

  • Surgical Oncology Physician
  • Las Vegas, NV
  • NPI 1083870554

  Single Specialty

  Medicare reassignment NPD
• Clyde Neal Ellis Jr., MD

  • Surgery Physician
  • Elkins, WV
  • NPI 1093762908

  NV

  Medicare reassignment NPD
• Amy Joseph, APRN

  • Internal Medicine Physician
  • Las Vegas, NV
  • NPI 1376557058
  NPD Authorized official

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

{
    "created_epoch": "1651795200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1705968000000",
    "number": "1679219349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "153 S RING DOVE DR",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891444351",
            "telephone_number": "617-895-7644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "653 N TOWN CENTER DR STE 506",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891440519",
            "telephone_number": "617-895-7644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMMIT SPECIALTY PHYSICIANS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-06",
        "last_updated": "2024-01-23",
        "certification_date": "2024-01-23",
        "status": "A",
        "authorized_official_last_name": "JOSEPH",
        "authorized_official_first_name": "AMY",
        "authorized_official_middle_name": "CAROLYN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "203-913-0661"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Summit Medical Group of Colorado PC
• Summit Medical Holdings LLC
• Summit Mental Health
• Summit Primary Care & Wellness
• Summit Ridge Calderon PC
• Summit Surgical Center LLC
• Summit Wellness of DPSW LLC
• Summit Wound Healing LLC
• Shalysha Summit
• Deandre Lamont Summlin

• Surgery Physician in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Surgery Physician in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.