Ascent Medical Group, Llc | |
2055 S Pacheco St Ste 600 Santa Fe NM 87505-3995 | |
(505) 930-5065 | |
Not Available |
Full Name | Ascent Medical Group, Llc |
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Speciality | Clinic/Center |
Location | 2055 S Pacheco St Ste 600, Santa Fe, New Mexico |
Authorized Official Name and Position | Brian Mathwich (CHIEF MEDICAL OFFICER) |
Authorized Official Contact | 3035795466 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Ascent Medical Group, Llc 2055 S Pacheco St Ste 600 Santa Fe NM 87505-3995 Ph: (303) 579-5466 | Ascent Medical Group, Llc 2055 S Pacheco St Ste 600 Santa Fe NM 87505-3995 Ph: (505) 930-5065 |
NPI Number | 1659093961 |
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Provider Enumeration Date | 09/13/2022 |
Last Update Date | 11/20/2023 |
Medicare PECOS PAC ID | 9335597939 |
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Medicare Enrollment ID | O20231120003094 |
Identifier | Type | State | Issuer |
---|---|---|---|
1659093961 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
Provider Name | Brian Neal Mathwich |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1194855734 PECOS PAC ID: 1153213749 Enrollment ID: I20230203000113 |
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