Active NPI
Paul A Vakselis, MD
- Surgery Physician
- Las Cruces, NM
National Provider Identifier
1710971015
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 2000120
- Practice address
- 2909 Hillrise Dr
Las Cruces, NM 88011-4701 - Phone
- (505) 522-5888
- Fax
- (505) 521-1876
- NPI assigned
- Sep 1, 2005
- 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 | 2000120 | NM | Primary |
Addresses
Primary practice location
2909 Hillrise Dr
Las Cruces, NM 88011-4701
Mailing address
PO Box 1560
Las Cruces, NM 88004-1560
Phone (505) 647-8366
Other identifiers 8
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 850466870 | Other | NM | CHAMPUS |
| 54770 | Other | NM | PRESBYTERIAN |
| 74423 | Medicaid | NM | |
| NM009426 | Other | NM | BC/BS |
| 31557 | Other | NM | LOVELACE |
| 850460870 | Other | NM | CIMARRON SALUD |
| 020049262 | Other | NM | RR MEDICARE |
| 880110001 | Other | NM | WPS TRICARE |
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 |
|---|---|---|---|
| 2000120 | NM | MD | Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1125532800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1234224000000",
"number": "1710971015",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1560",
"city": "LAS CRUCES",
"state": "NM",
"postal_code": "880041560",
"telephone_number": "505-647-8366",
"fax_number": "505-647-8387"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2909 HILLRISE DR",
"city": "LAS CRUCES",
"state": "NM",
"postal_code": "880114701",
"telephone_number": "505-522-5888",
"fax_number": "505-521-1876"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VAKSELIS",
"first_name": "PAUL",
"middle_name": "A",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-09-01",
"last_updated": "2009-02-10",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "NM",
"license": "2000120",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CHAMPUS",
"identifier": "850466870",
"state": "NM"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PRESBYTERIAN",
"identifier": "54770",
"state": "NM"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "74423",
"state": "NM"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC/BS",
"identifier": "NM009426",
"state": "NM"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LOVELACE",
"identifier": "31557",
"state": "NM"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIMARRON SALUD",
"identifier": "850460870",
"state": "NM"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "020049262",
"state": "NM"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WPS TRICARE",
"identifier": "880110001",
"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 Feb 10, 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.