MEDICARE: SURGICAL ASSIST INNOVATIONS 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	246ZC0007X	Surgical Assistant

General Provider Information

NPI Number	:	1699627620
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SURGICAL ASSIST INNOVATIONS LLC

Provider Business Mailing Address
First Line	:	4301 CANADA PL NW
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87114-5638
Country	:	US
Telephone Number	:	505-400-1469
Fax Number	:	505-792-9401

Provider Business Practice Location Address
First Line	:	4301 CANADA PL NW
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87114-5638
Country	:	US
Telephone Number	:	505-400-1469
Fax Number	:	505-792-9401

Authorized Official
Title or Position	:	CERTIFIED SURGICAL ASSISTANT
Name	:	MRS. ANGELA ANNETTE WINTERS
Credential	:	CSFA
Telephone Number	:	505-400-1469

Provider Enumeration Date	:	02/11/2026
Last Update Date	:	02/11/2026

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