NPIMap

Organization Active NPI

Ryan K Anderson D P M P C

Doing business as Foot and Ankle Specialists of Northern New Mexico

  • Foot & Ankle Surgery Podiatrist
  • Las Vegas, NM
National Provider Identifier
1700237278
Registry record updated Nov 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
Legal business name
RYAN K ANDERSON D P M P C
Doing business as
Foot and Ankle Specialists of Northern New Mexico
Practice address
105 Mills Ave
Ste 100
Las Vegas, NM 87701-4169
Phone
(505) 425-3569
Fax
(505) 434-0042
NPI assigned
Jun 27, 2016
Last updated
Nov 4, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2025

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

Authorized official

Name
Ryan K Anderson, DPMNPI 1053334730
Title
Owner
Phone
(801) 292-4425

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X NU
Foot & Ankle Surgery Podiatrist 213ES0103X NU Primary

Addresses

Primary practice location

105 Mills Ave
Ste 100
Las Vegas, NM 87701-4169

Mailing address

105 Mills Ave Ste 100
Las Vegas, NM 87701-4169
Phone (505) 425-3569

Other names 1

  • FOOT AND ANKLE SPECIALISTS OF NORTHERN NEW MEXICO Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20161220000986 NM DME Supplier - Physician - Podiatry 7517999121 Practice locations: Las Vegas, NM

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Ryan K Anderson DPM PC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

105 Mills Ave
Ste 100
Las Vegas, NM 87701
Phone (505) 425-3313

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1466985600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1762214400000",
    "number": "1700237278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 MILLS AVE STE 100",
            "city": "LAS VEGAS",
            "state": "NM",
            "postal_code": "877014169",
            "telephone_number": "505-425-3569",
            "fax_number": "505-434-0042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 MILLS AVE",
            "address_2": "STE 100",
            "city": "LAS VEGAS",
            "state": "NM",
            "postal_code": "877014169",
            "telephone_number": "505-425-3569",
            "fax_number": "505-434-0042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RYAN K ANDERSON D P M P C",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-27",
        "last_updated": "2025-11-04",
        "certification_date": "2025-11-04",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "RYAN",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "801-292-4425",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FOOT AND ANKLE SPECIALISTS OF NORTHERN NEW MEXICO",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Las Vegas, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2025; 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.