Individual provider Active NPI

Jesus J Fonseca, M.D.

  • Internal Medicine Physician
  • Hobbs, NM
National Provider Identifier
1093829400
Registry record updated Mar 8, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
2001-192 Issued in NM
Practice address
1923 N. Dal Paso, Suite a
Hobbs Medical Clinic
Hobbs, NM 88240-3023
Phone
(575) 433-3000
Fax
(575) 433-4451
NPI assigned
Aug 19, 2006
Last updated
Mar 8, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 2001-192 NM Primary

Addresses

Primary practice location

1923 N. Dal Paso, Suite a
Hobbs Medical Clinic
Hobbs, NM 88240-3023

Mailing address

1600 North Main
Lovington, NM 88260-2830
Phone (575) 396-6611

Other identifiers 1

IdentifierTypeStateIssuer
G2204MedicaidNM

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081217000588 NM Practitioner - Internal Medicine 5092877514 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University Central del Caribe Escuela de Medicina, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Nor-Lea Hospital DistrictGroup PAC ID 2466364534, 58 clinicians

Practice addresses (Care Compare)

515 E Main St
Hobbs, NM 88240-8119
Phone (575) 397-0560

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2001-192NMMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Nor-Lea Hospital District CurrentSince Oct 3, 2016 Accepting new patients
Sadler Clinic Association Past Accepting new patients
Medicine Clinic LLC Internal Medicine PastSince Aug 5, 2008 Accepting new patients
Pecos Valley of New Mexico, LLC Past Accepting new patients

Locations

1923 N Dal Paso St
Ste A
Hobbs, NM 88240
Phone (575) 433-3000

515 E Main St
Hobbs, NM 88240
Phone (575) 397-0560

1600 N Main Ave
Lovington, NM 88260
Phone (575) 396-6611

Interoperability endpoints

  • Direct secure messaging: jfonseca1266602@oc.providencedirect.org

Organizations & group practices 4

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

Hospital & facility affiliations 5

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": "1155945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488931200000",
    "number": "1093829400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 NORTH MAIN",
            "city": "LOVINGTON",
            "state": "NM",
            "postal_code": "882602830",
            "telephone_number": "575-396-6611",
            "fax_number": "575-396-1454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1923 N. DAL PASO, SUITE A",
            "address_2": "HOBBS MEDICAL CLINIC",
            "city": "HOBBS",
            "state": "NM",
            "postal_code": "882403023",
            "telephone_number": "575-433-3000",
            "fax_number": "575-433-4451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FONSECA",
        "first_name": "JESUS",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-19",
        "last_updated": "2017-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NM",
            "license": "2001-192",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "G2204",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hobbs, NM

Sources for this page

Verify at the official NPI Registry.