ADVANCED UROLOGY OF NEW MEXICO LLC (NPI# 1558667873) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558667873 |
| Entity Type | Organization |
| Organization Name | ADVANCED UROLOGY OF NEW MEXICO LLC |
| Practice Address |
3917 West Rd Suite 137 Los Alamos NM 87544-2275 |
| Practice Telephone | 5056618500 |
| Practice Fax Number | 5056610096 |
| Mailing Telephone | 5056618500 |
| Mailing Fax Number | 5056610096 |
| Enumeration Date | 2011-02-03 |
| Last Update Date | 2011-02-03 |
| Authorized Official Name | PAVEL V. MOURACHOV (OWNER) |
| Authorized Official Telephone | 5056618500 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208800000X | Urology | NM | Allopathic & Osteopathic Physicians |
| Street Address |
3917 WEST RD SUITE 137 |
| City | LOS ALAMOS |
| State | NM |
| Zip Code | 87544-2275 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225031321 | Jan M Merin | Internal Medicine | 3917 West Rd, Los Alamos, NM 87544-2275 | 2005-05-23 |
| 1366089237 | Gonzalo A Diaz | Internal Medicine | 3917 West Rd, Los Alamos, NM 87544-2275 | 2019-12-10 |
| 1124576327 | Clay Schneider | Nurse Practitioner | 3917 West Rd, Los Alamos, NM 87544-2275 | 2016-09-15 |
| 1093167330 | Laura K Merrigan | Nurse Practitioner | 3917 West Rd, Suite A, Los Alamos, NM 87544-2275 | 2016-07-11 |
| 1043675473 | Total Renal Care Inc | Clinic/Center | 3917 West Rd, Ste G-02, Los Alamos, NM 87544-2275 | 2015-12-30 |
| 1225414253 | Sarah Versackas | Registered Nurse | 3917 West Rd, Suite A, Los Alamos, NM 87544-2275 | 2015-07-31 |
| 1700273745 | Apogee Medical Group | General Acute Care Hospital | 3917 West Rd, Los Alamos, NM 87544-2275 | 2015-04-16 |
| 1679965883 | Los Alamos Emergency Medical Associates Inc | Emergency Medicine | 3917 West Rd, Los Alamos, NM 87544-2275 | 2015-02-25 |
| 1659773612 | Eric Jonathan Krinsky | Physician Assistant | 3917 West Rd, Suite 150, Los Alamos, NM 87544-2275 | 2014-09-22 |
| 1740681311 | Robin Jean Norman | Physician Assistant | 3917 West Rd, Suite 150, Los Alamos, NM 87544-2275 | 2014-09-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679945935 | Zia Home Health | Home Health | 1475 Central Ave., Suite 125, Los Alamos, NM 87544 | 2015-10-27 |
| 1295131167 | Sara Pocernik | Dietitian, Registered | 1450 Iris Street, Los Alamos, NM 87544 | 2014-11-05 |
| 1760824890 | Lisa Renee Marr Lyon | Psychologist | 3917 West Road, Suite 128, Children's Clinic, P.a., Los Alamos, NM 87544 | 2013-07-17 |
| 1558629725 | Rachel Meyer | Dentist | 112 Central Park Square, Los Alamos, NM 87544 | 2012-04-25 |
| 1902183908 | Susana T. Chavarria | Occupational Therapist | 5 Quemazon Pl., Los Alamos, NM 87544 | 2011-11-04 |
| 1881998664 | Dr. Tom Child and Adolescent Medicine | Pediatrics | Los Alamos Medical Center, 3917 West Rd, Suite M250, Los Alamos, NM 87544 | 2011-01-07 |
| 1952565905 | Dawn Judy Barr | Social Worker | 3 Agila Ct, Los Alamos, NM 87544 | 2008-07-17 |
| 1649452129 | Ellen Vandergust Ballard | Dentist | 111 Longview, Suite B-3, White Rock, NM 87544 | 2007-11-27 |
| 1629290283 | Wildwind Dental | Dentist | 111 Longview Drive, Suite B3, Los Alamos, NM 87544 | 2007-05-03 |
| 1255407342 | Sarah Sue Teasdale | Counselor | 1362 C Trinity Dr, Los Alamos, NM 87544 | 2006-11-28 |
| Find all providers in zip 87544 | ||||
| Taxonomy Code | 208800000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Urology |
| A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Urology, 2007. http://www.abu.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Urology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902050040 | Los Alamos Physician Practices LLC | Urology | 3917 West Rd, Suite 137, Los Alamos, NM 87544-2275 | 2008-11-14 |
| 1083711121 | Pavel Mourachov | Urology | 3917 West Rd, Ste 137, Los Alamos, NM 87544 | 2006-09-20 |
| 1073548665 | James Gordon Knight | Urology | 3917 West Rd, Ste 138, Los Alamos, NM 87544-2275 | 2006-07-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801162003 | Margaret N Le | Urology | 4801 Beckner Rd Ste 1700, Santa Fe, NM 87507-3641 | 2012-04-01 |
| 1982925673 | Christopher Robert Vesely Hoover | Urology | 1900 Red Rock Dr, Gallup, NM 87301-5682 | 2010-06-16 |
| 1174849210 | Jessica Megan Chen Ming | Urology | 1004 Columbia Dr Ne, Albuquerque, NM 87106-2627 | 2010-04-14 |
| 1346474913 | Arthur Anthony Caire V | Urology | 350 W Country Club Rd Ste 205, Roswell, NM 88201-5221 | 2009-05-11 |
| 1306009840 | Robert M Zone | Urology | 14 General Sage Dr, Santa Fe, NM 87505-6337 | 2008-07-03 |
| 1174693782 | Robert W Frasier IIi | Urology | 612 N Paseo De Onate Ste D, Espanola, NM 87532-2963 | 2006-11-09 |
| 1023111374 | Sergio Jose Rybka | Urology | 1013 N Thomas St, Carlsbad, NM 88220-4575 | 2006-09-05 |
| 1932202280 | Sergio J Rybka Md PC | Urology | 1031 N Thomas St, Carlsbad, NM 88220 | 2006-09-05 |
| 1568493773 | Richard Saul Diaz Tushman | Urology | 2402 W Pierce St Ste 6f, Carlsbad, NM 88220-3566 | 2006-07-05 |
| 1598743056 | Steven Arrowsmith | Urology | 1900 Redrock Dr, Rehoboth Mckinley Christian Health Care Services, Gallup, NM 87301-5682 | 2006-01-05 |
| Find all providers with the same taxonomy | ||||
| City | LOS ALAMOS |
| Zip Code | 87544 |
Please comment or provide details below to improve the information on ADVANCED UROLOGY OF NEW MEXICO LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.