Organization Active NPI

Southwest Center on Aging

  • Internal Medicine Physician
  • Las Cruces, NM
National Provider Identifier
1003143660
Registry record updated Apr 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD2008-0053 Issued in NM
Legal business name
SOUTHWEST CENTER ON AGING
Practice address
1106 Centre CT
Las Cruces, NM 88011-8154
Phone
(575) 532-5455
Fax
(575) 532-5641
NPI assigned
Nov 3, 2009
Last updated
Apr 24, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Jesus Roberto Duran, M.D.NPI 1972714806
Title
Owner
Phone
(575) 647-8366

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD2008-0053 NM Primary

Addresses

Primary practice location

1106 Centre CT
Las Cruces, NM 88011-8154

Mailing address

1106 Centre CT
Las Cruces, NM 88011-8154
Phone (575) 532-5455

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100222000225 NM Part B Supplier - Clinic/Group Practice 9830233378 Receives reassigned benefits from 7 practitioners
Practice locations: Las Cruces, NM

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
32D2001911Southwest Center on Aging1106 Centre Court, Las Cruces, NM 88011Certificate of waiverJan 3, 2028

National Provider Directory

National Provider Directory

Locations

1106 Centre Ct
Las Cruces, NM 88011
Phone (575) 532-5455

2467 S Telshor Blvd
Las Cruces, NM 88011
Phone (505) 522-5558

Practitioners & affiliated clinicians

Practitioners 19

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 19

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1257206400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1745452800000",
    "number": "1003143660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1106 CENTRE CT",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880118154",
            "telephone_number": "575-532-5455",
            "fax_number": "575-532-5641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1106 CENTRE CT",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880118154",
            "telephone_number": "575-532-5455",
            "fax_number": "575-532-5641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHWEST CENTER ON AGING",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-03",
        "last_updated": "2025-04-24",
        "certification_date": "2025-04-24",
        "status": "A",
        "authorized_official_last_name": "DURAN",
        "authorized_official_first_name": "JESUS",
        "authorized_official_middle_name": "ROBERTO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "575-647-8366",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NM",
            "license": "MD2008-0053",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Cruces, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.