Individual provider Active NPI

Daniel J Zemek

  • Adult Health Nurse Practitioner
  • Las Cruces, NM
National Provider Identifier
1154481547
Registry record updated Aug 26, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
CNP00824 Issued in NM
Practice address
1809 Imperial RDG
Las Cruces, NM 88011-4811
Phone
(505) 647-7642
Fax
(505) 647-7630
NPI assigned
Dec 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X R37709 NM
Adult Health Nurse Practitioner 363LA2200X CNP00824 NM Primary

Addresses

Primary practice location

1809 Imperial RDG
Las Cruces, NM 88011-4811

Mailing address

1809 Imperial RDG
Las Cruces, NM 88011-4811
Phone (505) 647-7642

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
I20050409000063 NM Practitioner - Nurse Practitioner 1557308772 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R37709NMMDRegistered Nurse
CNP00824NMMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
BHC Mesilla Valley Hospital LLC CurrentSince Oct 30, 2006 Accepting new patients
New Mexico Quickcare LLC Past Accepting new patients

Locations

3571 Del Rey Blvd
Mesillia Vly Hosp
Las Cruces, NM 88012
Phone (575) 373-5043

3751 Del Rey Blvd
Las Cruces, NM 88012
Phone (505) 382-3500

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1165536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409011200000",
    "number": "1154481547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1809 IMPERIAL RDG",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880114811",
            "telephone_number": "505-647-7642",
            "fax_number": "505-647-7630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1809 IMPERIAL RDG",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880114811",
            "telephone_number": "505-647-7642",
            "fax_number": "505-647-7630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZEMEK",
        "first_name": "DANIEL",
        "middle_name": "J",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-08",
        "last_updated": "2014-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NM",
            "license": "R37709",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NM",
            "license": "CNP00824",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Cruces, NM

Sources for this page

Verify at the official NPI Registry.