Dermatology of Las Cruces, PC

Primary specialty

SpecialistTaxonomy code 174400000X

License

97-332 Issued in NM

Legal business name

DERMATOLOGY OF LAS CRUCES, PC

Practice address

3865 Foothills Rd
Las Cruces, NM 88011-5091

Phone

(575) 521-7117

Fax

(575) 521-7226

NPI assigned

Feb 6, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Andrew L Ondo, M.D.NPI 1275536559

Title

Owner/Physician

Phone

(575) 521-7117

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NM

Enrollment records 1

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

CLIA laboratory certificates

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Andrew L Ondo, M.D.

  • Dermatology Physician
  • Las Cruces, NM
  • NPI 1275536559
  Medicare reassignment Care Compare group NPD Authorized official
• Jilana Gladstone, PA-C

  • Medical Physician Assistant
  • Las Cruces, NM
  • NPI 1518935105
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1423180800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1464652800000",
    "number": "1780075135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3865 FOOTHILLS RD",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880115091",
            "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": "3865 FOOTHILLS RD",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880115091",
            "telephone_number": "575-521-7117",
            "fax_number": "575-521-7226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DERMATOLOGY OF LAS CRUCES, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-06",
        "last_updated": "2016-05-31",
        "status": "A",
        "authorized_official_last_name": "ONDO",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER/PHYSICIAN",
        "authorized_official_telephone_number": "575-521-7117",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "NM",
            "license": "97-332",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Specialist in Las Cruces, NM
• Providers in Las Cruces, NM by specialty
• Specialist in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2016; 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.