MEDICARE: ADVANCED AMBULATORY SURGERY CENTER OF CARLSBAD NM, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RC0000X	Cardiovascular Disease Physician
2	261QA1903X	Ambulatory Surgical Clinic/Center

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1689393746
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADVANCED AMBULATORY SURGERY CENTER OF CARLSBAD NM, LLC

Provider Business Mailing Address
First Line	:	1619 SKYLINE CIR STE B
Second Line	:
City	:	CARLSBAD
State	:	NM
Zip	:	88220-9842
Country	:	US
Telephone Number	:	575-941-2455
Fax Number	:	833-620-2406

Provider Business Practice Location Address
First Line	:	1619 SKYLINE CIRCLE
Second Line	:	SUITE B
City	:	CARLSBAD
State	:	NM
Zip	:	88220-3513
Country	:	US
Telephone Number	:	575-202-0630
Fax Number	:	888-572-7765

Authorized Official
Title or Position	:	DIRECTOR OF RCM
Name	:	JESIRAE TORRES
Credential	:
Telephone Number	:	575-941-2455

Provider Enumeration Date	:	08/23/2022
Last Update Date	:	02/06/2026

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