NPIMap

Organization Active NPI

Los Alamos Physician Practices, LLC

Doing business as Los Alamos General Surgery Clinic

  • Surgery Physician
  • Los Alamos, NM
National Provider Identifier
1801075783
Registry record updated Oct 29, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
LOS ALAMOS PHYSICIAN PRACTICES, LLC
Doing business as
Los Alamos General Surgery Clinic
Practice address
3917 West Rd
#125
Los Alamos, NM 87544-2275
Phone
(505) 661-3030
NPI assigned
Oct 29, 2007
Last updated
Oct 29, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2007

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

Authorized official

Name
Angie Mangum
Title
Director
Phone
(505) 521-5277

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208600000X Primary

Addresses

Primary practice location

3917 West Rd
#125
Los Alamos, NM 87544-2275

Mailing address

PO Box 129
Los Alamos, NM 87544-0129

Other names 1

  • Los Alamos General Surgery Clinic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20061104000041 NM Part B Supplier - Clinic/Group Practice 4587661541 Receives reassigned benefits from 43 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Los Alamos, NM; Espanola, NM

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

3917 West Rd
#125
Los Alamos, NM 87544
Phone (505) 661-3030

3917 West Rd
Ste 138
Los Alamos, NM 87544
Phone (505) 661-9030

3917 West Rd
Ste 139
Los Alamos, NM 87544
Phone (505) 661-3030

Practitioners & affiliated clinicians

Practitioners 41

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.

View all 41

NPI Registry JSON

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

{
    "created_epoch": "1193616000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193616000000",
    "number": "1801075783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 129",
            "city": "LOS ALAMOS",
            "state": "NM",
            "postal_code": "875440129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3917 WEST RD",
            "address_2": "#125",
            "city": "LOS ALAMOS",
            "state": "NM",
            "postal_code": "875442275",
            "telephone_number": "505-661-3030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOS ALAMOS PHYSICIAN PRACTICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-29",
        "last_updated": "2007-10-29",
        "status": "A",
        "authorized_official_last_name": "MANGUM",
        "authorized_official_first_name": "ANGIE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "505-521-5277"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Los Alamos General Surgery Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Los Alamos, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2007; 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.