Individual provider Active NPI

Ralph T Zych, PAC

  • Surgical Physician Assistant
  • Albuquerque, NM
National Provider Identifier
1902800717
Registry record updated Jan 3, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
81PA014 Issued in NM
Practice address
6801 Jefferson St NE
Suite 350
Albuquerque, NM 87109-4379
Phone
(505) 242-1711
Fax
(505) 242-0291
NPI assigned
Jun 9, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 81PA014 NM Primary

Addresses

Primary practice location

6801 Jefferson St NE
Suite 350
Albuquerque, NM 87109-4379

Mailing address

6801 Jefferson St NE
Suite 350
Albuquerque, NM 87109-4379
Phone (505) 242-1711

Other identifiers 1

IdentifierTypeStateIssuer
94471MedicaidNM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
81PA014NMMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
New Mexico Heart Institute, LLC Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1118275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294012800000",
    "number": "1902800717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6801 JEFFERSON ST NE",
            "address_2": "SUITE 350",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871094379",
            "telephone_number": "505-242-1711",
            "fax_number": "505-242-0291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6801 JEFFERSON ST NE",
            "address_2": "SUITE 350",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871094379",
            "telephone_number": "505-242-1711",
            "fax_number": "505-242-0291"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZYCH",
        "first_name": "RALPH",
        "middle_name": "T",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-09",
        "last_updated": "2011-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NM",
            "license": "81PA014",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "94471",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2011; 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.