Organization Active NPI

Summits Healthcare, LLC

Doing business as Summit Healthcare

  • Family Nurse Practitioner
  • Deming, NM
National Provider Identifier
1740833243
Registry record updated Jan 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
SUMMITS HEALTHCARE, LLC
Doing business as
Summit Healthcare
Practice address
111 N Pearl St
Deming, NM 88030-3835
Phone
(575) 517-2725
Fax
(575) 517-2280
NPI assigned
Jul 23, 2019
Last updated
Jan 1, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 1, 2024

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

Authorized official

Name
Eduard Schander, CNPNPI 1700269271
Title
Owner/Provider
Phone
(717) 331-4676

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X Primary

Addresses

Primary practice location

111 N Pearl St
Deming, NM 88030-3835

Mailing address

111 N Pearl St
Deming, NM 88030-3835
Phone (575) 517-2725

Other names 1

  • Summit Healthcare Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20191211000560 NM Part B Supplier - Clinic/Group Practice 9133552813 Receives reassigned benefits from 6 practitioners
Practice locations: Deming, NM

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
32D2026615Summit's Healthcare111 N Pearl St, Deming, NM 88030Certificate of waiverJul 5, 2027

National Provider Directory

National Provider Directory

Locations

111 N Pearl St
Deming, NM 88030
Phone (575) 517-2725

Practitioners & affiliated clinicians

Practitioners 8

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": "1563840000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1704067200000",
    "number": "1740833243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 N PEARL ST",
            "city": "DEMING",
            "state": "NM",
            "postal_code": "880303835",
            "telephone_number": "575-517-2725",
            "fax_number": "575-517-2280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 N PEARL ST",
            "city": "DEMING",
            "state": "NM",
            "postal_code": "880303835",
            "telephone_number": "575-517-2725",
            "fax_number": "575-517-2280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMMITS HEALTHCARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-23",
        "last_updated": "2024-01-01",
        "certification_date": "2024-01-01",
        "status": "A",
        "authorized_official_last_name": "SCHANDER",
        "authorized_official_first_name": "EDUARD",
        "authorized_official_title_or_position": "OWNER/PROVIDER",
        "authorized_official_telephone_number": "717-331-4676",
        "authorized_official_credential": "CNP"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Summit Healthcare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Deming, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.