Active NPI
Faustino M Naldoza Jr., M.D.
- Surgery Physician
- Wellington, KS
National Provider Identifier
1902820301
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 4-15591
- Practice address
- 1323 N a St
Wellington, KS 67152-4350 - Phone
- (620) 326-8171
- Fax
- (620) 326-2371
- NPI assigned
- Jul 27, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 4-15591 | KS | Primary |
Addresses
Primary practice location
1323 N a St
Wellington, KS 67152-4350
Mailing address
1323 N a St
Wellington, KS 67152-4350
Phone (620) 326-8171
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000334 | Other | KS | BC/BS PROVIDER # |
| 100088410A | Medicaid | KS |
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
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4-15591 | KS | MD | Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wellington Family Practice Clinic LLP | 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.
-
- Family Medicine Physician
- Wellington, KS
- NPI 1083622310
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153958400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1217289600000",
"number": "1902820301",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1323 N A ST",
"city": "WELLINGTON",
"state": "KS",
"postal_code": "671524350",
"telephone_number": "620-326-8171",
"fax_number": "620-326-2371"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1323 N A ST",
"city": "WELLINGTON",
"state": "KS",
"postal_code": "671524350",
"telephone_number": "620-326-8171",
"fax_number": "620-326-2371"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NALDOZA",
"first_name": "FAUSTINO",
"middle_name": "M",
"name_suffix": "Jr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-27",
"last_updated": "2008-07-29",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "KS",
"license": "4-15591",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC/BS PROVIDER #",
"identifier": "000334",
"state": "KS"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100088410A",
"state": "KS"
}
],
"endpoints": [],
"other_names": []
}Other providers in Wellington, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.