Individual provider Active NPI

Hector Anibal Ponce Sr., AGNP

  • Nurse Practitioner
  • Las Cruces, NM
National Provider Identifier
1083485213
Registry record updated Jan 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
77261 Issued in NM
Practice address
3900 E Lohman Ave Ste B
Las Cruces, NM 88011-8268
Phone
(575) 522-5752
Fax
(575) 522-5722
NPI assigned
Jan 16, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 77261 NM Primary

Addresses

Primary practice location

3900 E Lohman Ave Ste B
Las Cruces, NM 88011-8268

Mailing address

12848 Tierra Pueblo
El Paso, TX 79938-4303
Phone (915) 217-6585

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240215003304 NM Practitioner - Nurse Practitioner 5092159228 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Renal Medicine Associates LTD.Group PAC ID 1052217585, 37 clinicians

Practice addresses (Care Compare)

3900 E Lohman Ave
Suite B
Las Cruces, NM 88011-8268
Phone (575) 522-5752

Hospital & facility affiliations

  • Memorial Medical Center Hospital, Las Cruces, NM, CCN 320018
  • Mountain View Regional Medical Center Hospital, Las Cruces, NM, CCN 320085
  • Mimbres Valley Medical Center Hospital, Deming, NM, CCN 321309
  • Three Crosses Regional Hospital LLC Hospital, Las Cruces, NM, CCN 320091

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
77261NMMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Otero County Hospital Association CurrentSince Mar 25, 2024 Accepting new patients
Renal Medicine Associates LTD. CurrentSince Feb 1, 2024 Accepting new patients
Otero County Hospital Association CurrentSince Mar 25, 2024 Accepting new patients

Locations

2669 Scenic Dr
Alamogordo, NM 88310
Phone (505) 439-6100

3821 Masthead St NE
Albuquerque, NM 87109
Phone (505) 998-7400

3900 E Lohman Ave
Ste B
Las Cruces, NM 88011
Phone (575) 522-5752

313 W Country Club Rd
Ste 12
Roswell, NM 88201
Phone (505) 627-5828

Interoperability endpoints

  • Direct secure messaging: hponce61629@direct.acumenmd.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1705363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705363200000",
    "number": "1083485213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12848 TIERRA PUEBLO",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799384303",
            "telephone_number": "915-217-6585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3900 E LOHMAN AVE STE B",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880118268",
            "telephone_number": "575-522-5752",
            "fax_number": "575-522-5722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PONCE",
        "first_name": "HECTOR",
        "middle_name": "ANIBAL",
        "name_suffix": "Sr.",
        "credential": "AGNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-01-16",
        "last_updated": "2024-01-16",
        "certification_date": "2024-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NM",
            "license": "77261",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Cruces, NM

Sources for this page

Verify at the official NPI Registry.