Individual provider Active NPI

Elias N Nasr, MD

  • Surgery Physician
  • Sierra Vista, AZ
National Provider Identifier
1912072604
Registry record updated Oct 1, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
36124 Issued in AZ
Practice address
155 Calle Portal
Suite 400
Sierra Vista, AZ 85635-2900
Phone
(520) 458-0229
Fax
(520) 458-1038
NPI assigned
Nov 21, 2006
Last updated
Oct 1, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 36124 AZ Primary
Surgical Oncology Physician 2086X0206X 36124 AZ

Addresses

Primary practice location

155 Calle Portal
Suite 400
Sierra Vista, AZ 85635-2900

Mailing address

302 El Camino Real
Ste 5
Sierra Vista, AZ 85635-2860
Phone (520) 458-4335

Other identifiers 1

IdentifierTypeStateIssuer
159997MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121108000373 NM Practitioner - General Surgery 9234139940 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Presbyterian Healthcare Services Family Medicine CurrentSince Nov 4, 2012 Accepting new patients
Presbyterian Healthcare Services CurrentSince Nov 4, 2012 Accepting new patients
Sierra Vista Regional Health Center Medical Group LLC Family Medicine Past Accepting new patients
Advanced Surgical Associates PA Surgery Past Accepting new patients
MD Med Inc Past Accepting new patients
Regional Care Physicians Grooup Family Medicine Past Accepting new patients

Locations

201 Cedar St SE
Ste 306
Albuquerque, NM 87106
Phone (505) 247-3635

2200 W 21st St
Clovis, NM 88101
Phone (505) 769-7577

Interoperability endpoints

  • Direct secure messaging: enasr46125@direct.phs.org

Organizations & group practices 6

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

NPI Registry JSON

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

{
    "created_epoch": "1164067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1285891200000",
    "number": "1912072604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "302 EL CAMINO REAL",
            "address_2": "STE 5",
            "city": "SIERRA VISTA",
            "state": "AZ",
            "postal_code": "856352860",
            "telephone_number": "520-458-4335",
            "fax_number": "520-452-2232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 CALLE PORTAL",
            "address_2": "SUITE 400",
            "city": "SIERRA VISTA",
            "state": "AZ",
            "postal_code": "856352900",
            "telephone_number": "520-458-0229",
            "fax_number": "520-458-1038"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NASR",
        "first_name": "ELIAS",
        "middle_name": "N",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-21",
        "last_updated": "2010-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "AZ",
            "license": "36124",
            "primary": true
        },
        {
            "code": "2086X0206X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Oncology",
            "state": "AZ",
            "license": "36124",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "159997",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sierra Vista, AZ

Sources for this page

Verify at the official NPI Registry.