Individual provider Active NPI

Shae M Pallares, CNM

  • Advanced Practice Midwife
  • Las Cruces, NM
National Provider Identifier
1205543865
Registry record updated Oct 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
876 Issued in NM
Practice address
4351 E Lohman Ave Ste 402
Las Cruces, NM 88011-8261
Phone
(575) 522-4767
NPI assigned
Nov 3, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Midwife 367A00000X 876 NM Primary

Addresses

Primary practice location

4351 E Lohman Ave Ste 402
Las Cruces, NM 88011-8261

Mailing address

1726 Royal Dr
Las Cruces, NM 88011-4926
Phone (575) 644-8747

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240810000293 NM Practitioner - Certified Nurse Midwife (CNM) 5597133322 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife

State licenses

LicenseStateTypeSpecialty
876NMMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Las Cruces Physician Services LLC CurrentSince Jul 1, 2024 Accepting new patients
Familycare Associates,PA Past Accepting new patients

Locations

1135 S Main St
Ste B
Las Cruces, NM 88005
Phone (505) 522-5205

4351 E Lohman Ave
Ste 402
Las Cruces, NM 88011
Phone (505) 522-0329

4351 E Lohman Ave
Ste 401
Las Cruces, NM 88011
Phone (505) 522-4767

Interoperability endpoints

  • Direct secure messaging: shae.pallares.1@1928.direct.athenahealth.com

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": "1667433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727913600000",
    "number": "1205543865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1726 ROYAL DR",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880114926",
            "telephone_number": "575-644-8747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4351 E LOHMAN AVE STE 402",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880118261",
            "telephone_number": "575-522-4767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALLARES",
        "first_name": "SHAE",
        "middle_name": "M",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-11-03",
        "last_updated": "2024-10-03",
        "certification_date": "2024-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "NM",
            "license": "876",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Cruces, NM

Sources for this page

Verify at the official NPI Registry.