Provider Demographics
NPI:1750356820
Name:ORTHOPEDIC ASSOCIATES PA
Entity type:Organization
Organization Name:ORTHOPEDIC ASSOCIATES PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:KAY
Authorized Official - Last Name:COMPTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:505-327-1400
Mailing Address - Street 1:2300 E 30TH ST BLDG D
Mailing Address - Street 2:STE 101
Mailing Address - City:FARMINGTON
Mailing Address - State:NM
Mailing Address - Zip Code:87401-8990
Mailing Address - Country:US
Mailing Address - Phone:505-327-1400
Mailing Address - Fax:505-564-3202
Practice Address - Street 1:2300 E 30TH ST STE 101
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:NM
Practice Address - Zip Code:87401-8990
Practice Address - Country:US
Practice Address - Phone:505-327-1400
Practice Address - Fax:505-564-3202
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-21
Last Update Date:2024-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
No213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
00NM005061OtherBCBS
NM47522Medicaid
NM47522Medicaid
NM=========OtherLOVELACE/CIGNA/BCBS ID#
NM2371766Medicare PIN
00NM005061OtherBCBS