NPIMap

Organization Active NPI

Los Alamos Medical Care Clinic LTD

  • Multi-Specialty Clinic/Center
  • Los Alamos, NM
National Provider Identifier
1801816293
Registry record updated Feb 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
LOS ALAMOS MEDICAL CARE CLINIC LTD
Practice address
3917 West Rd
Suite 150
Los Alamos, NM 87544
Phone
(505) 662-4351
Fax
(505) 662-2932
NPI assigned
Jul 20, 2006
Last updated
Feb 20, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2020

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

Authorized official

Name
Claudette Medina
Title
Office Manager
Phone
(505) 662-4351

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy & Immunology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207K00000X
Dermatology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207N00000X
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X
Multi-Specialty Clinic/Center 261QM1300X Primary

Addresses

Primary practice location

3917 West Rd
Suite 150
Los Alamos, NM 87544

Mailing address

3917 West Rd
Suite 150
Los Alamos, NM 87544
Phone (505) 662-4351

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040322001618 NM Part B Supplier - Clinic/Group Practice 4284525007 Receives reassigned benefits from 11 practitioners
Practice locations: Los Alamos, NM

National Provider Directory

National Provider Directory

Locations

3917 West Rd
Ste 150
Los Alamos, NM 87544
Phone (505) 662-4351

Practitioners & affiliated clinicians

Practitioners 11

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": "1153353600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1582156800000",
    "number": "1801816293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3917 WEST RD",
            "address_2": "SUITE 150",
            "city": "LOS ALAMOS",
            "state": "NM",
            "postal_code": "87544",
            "telephone_number": "505-662-4351",
            "fax_number": "505-662-2932"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3917 WEST RD",
            "address_2": "SUITE 150",
            "city": "LOS ALAMOS",
            "state": "NM",
            "postal_code": "87544",
            "telephone_number": "505-662-4351",
            "fax_number": "505-662-2932"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOS ALAMOS MEDICAL CARE CLINIC LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-20",
        "last_updated": "2020-02-20",
        "certification_date": "2020-02-20",
        "status": "A",
        "authorized_official_last_name": "MEDINA",
        "authorized_official_first_name": "CLAUDETTE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "505-662-4351"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Allergy & Immunology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Feb 20, 2020; 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.