NPIMap

Organization Active NPI

Las Cruces Dermatology Associates P.C.

  • Specialist
  • Las Cruces, NM
National Provider Identifier
1720018468
Registry record updated May 28, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
97-332 Issued in NM
Legal business name
LAS CRUCES DERMATOLOGY ASSOCIATES P.C.
Practice address
4351 E Lohman Ave
Ste. 208
Las Cruces, NM 88011-8259
Phone
(575) 521-7117
Fax
(575) 521-7226
NPI assigned
Jul 4, 2006
Last updated
May 28, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 28, 2009

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

Authorized official

Name
Dr. Andrew Luke Ondo, MDNPI 1275536559
Title
Owner
Phone
(575) 521-7117

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 97-332 NM Primary

Addresses

Primary practice location

4351 E Lohman Ave
Ste. 208
Las Cruces, NM 88011-8259

Mailing address

4351 E Lohman Ave
Ste. 208
Las Cruces, NM 88011-8259
Phone (575) 521-7117

Other identifiers 1

IdentifierTypeStateIssuer
NM011341OtherNMBLUE CROSS BLUE SHIELD

National Provider Directory

National Provider Directory

Locations

4351 E Lohman Ave
Ste 208
Las Cruces, NM 88011
Phone (505) 521-7117

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": "1151971200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1243468800000",
    "number": "1720018468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4351 E LOHMAN AVE",
            "address_2": "STE. 208",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880118259",
            "telephone_number": "575-521-7117",
            "fax_number": "575-521-7226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4351 E LOHMAN AVE",
            "address_2": "STE. 208",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880118259",
            "telephone_number": "575-521-7117",
            "fax_number": "575-521-7226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAS CRUCES DERMATOLOGY ASSOCIATES P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-04",
        "last_updated": "2009-05-28",
        "status": "A",
        "authorized_official_last_name": "ONDO",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_middle_name": "LUKE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "575-521-7117",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NM",
            "license": "97-332",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "NM011341",
            "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 28, 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.