Los Alamos Emergency Medical Associates Inc
Organization Active NPI Emergency Medicine Physician · Los Alamos, NM
NPI 1679965883 · NPPES record last updated Aug 4, 2022
Key facts
- NPI
- 1679965883
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Emergency Medicine Physician 207P00000X
- Legal business name
- LOS ALAMOS EMERGENCY MEDICAL ASSOCIATES INC
- Practice address
- 3917 West Rd
Los Alamos, NM 87544-2275 - Phone
- (310) 321-0143
- Fax
- (310) 379-4856
- NPI assigned
- Feb 25, 2015
- Organization subpart
- No
Authorized official
- Name
- Irv Edwards, MD
- Title
- President
- Phone
- (310) 321-0143
Practitioners 32
-
Josiah H Child, M.D.
-
Miguel T Dozier, MD
-
David Scott Fischman, M.D.
-
Gary Kanner, MD
-
Eric M Ketcham, M.D.
-
Michael Lara, M.D.
-
Andrew Leamon, MD
-
Bailey Lynn, M.D.
-
Valerie Merl, MD
-
Paul A Mikkelson, M.D.
-
Victor L Sherman, M.D.
-
Kenneth Stewart, MD
-
Kateland Townley, MD
-
Peter James Bloomfield, M.D.
-
Samuel I Decker, MD
-
Anthony Dowidowicz, M.D.,
-
Alan Miles Heilpern, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NM
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20150501001381 | NM | Part B Supplier - Clinic/Group Practice | 1557680105 |
Receives reassigned benefits from 30 practitioners Practice locations: Los Alamos, NM |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician |
207P00000X | Yes |
Addresses
Primary practice location
3917 West Rd
Los Alamos, NM 87544-2275
Mailing address
PO Box 80261
City of Industry, CA 91716-8261
Phone (310) 321-0143
NPI Registry JSON
{
"created_epoch": "1424822400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1659571200000",
"number": "1679965883",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 80261",
"city": "CITY OF INDUSTRY",
"state": "CA",
"postal_code": "917168261",
"telephone_number": "310-321-0143",
"fax_number": "310-379-4856"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3917 WEST RD",
"city": "LOS ALAMOS",
"state": "NM",
"postal_code": "875442275",
"telephone_number": "310-321-0143",
"fax_number": "310-379-4856"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "LOS ALAMOS EMERGENCY MEDICAL ASSOCIATES INC",
"organizational_subpart": "NO",
"enumeration_date": "2015-02-25",
"last_updated": "2022-08-04",
"certification_date": "2022-08-04",
"status": "A",
"authorized_official_last_name": "EDWARDS",
"authorized_official_first_name": "IRV",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "310-321-0143",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Emergency Medicine",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Alamos, NM
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- Los Alamos Chiropractic Center
- Los Alamos Family Council, Inc.
- Los Alamos Family Eyecare, P.C.
- Los Alamos Family Practice P a
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All providers in Los Alamos, NM · Emergency Medicine Physician in New Mexico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 4, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.