Las Cruces Physician Services LLC

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

77-108 Issued in NM

Legal business name

LAS CRUCES PHYSICIAN SERVICES LLC

Practice address

4351 E Lohman Ave
Suite 200
Las Cruces, NM 88011-8259

Phone

(505) 556-7737

NPI assigned

Feb 13, 2007

Organization subpart

No

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

Authorized official

Name

Jennifer L Jackson

Title

Senior Director, Enrollment

Phone

(877) 892-9815

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NM, TX, OK, FL, CA, IN, NJ, HI, NC, AZ, NY, MA, MS, DE, SC15 enrollments

Enrollment records 15

Locations (25 of 34)

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Las Cruces Physician Services LLC

  • Durable Medical Equipment & Medical Supplies
  • Las Cruces, NM
  • NPI 1669708467
  NPPES parent name

Practitioners 204

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• William Thomas Baker, D.O.

  • Family Medicine Physician
  • Las Cruces, NM
  • NPI 1215913447

  NM

  Medicare reassignment Care Compare group NPD
• Renata Brodsky, DO

  • Surgery Physician
  • Las Cruces, NM
  • NPI 1497983274

  NM

  Medicare reassignment Care Compare group NPD
• Samuel Correa Bustillos, ACNP-AG

  • Acute Care Nurse Practitioner
  • Las Cruces, NM
  • NPI 1699289173

  NM

  Medicare reassignment Care Compare group NPD
• Craig Frederick Cannon, M.D.

  • Cardiovascular Disease Physician
  • Las Cruces, NM
  • NPI 1013025568

  NM

  Medicare reassignment Care Compare group NPD
• Angelina Paz Carver, CFNP

  • Family Nurse Practitioner
  • Las Cruces, NM
  • NPI 1578563136

  NM

  Medicare reassignment Care Compare group NPD
• Kristen Renee Castillo, MD

  • Obstetrics & Gynecology Physician
  • Las Cruces, NM
  • NPI 1396820734

  NM

  Medicare reassignment Care Compare group NPD
• Mark Cavaretta, MD

  • Surgery Physician
  • Las Cruces, NM
  • NPI 1942400643

  NM

  Medicare reassignment Care Compare group NPD
• Ashley Childs, DNP, APRN, FNP-BC

  • Family Nurse Practitioner
  • Carlsbad, NM
  • NPI 1457124679

  NM

  Medicare reassignment Care Compare group NPD
• Bronwyn S Davis, FNP

  • Family Nurse Practitioner
  • Las Cruces, NM
  • NPI 1174119309

  NM

  Medicare reassignment Care Compare group NPD
• Paula Esmeralda Delgado, MD

  • Obstetrics & Gynecology Physician
  • Las Cruces, NM
  • NPI 1477182046

  NM

  Medicare reassignment Care Compare group NPD
• Lance Dell, MD

  • Diagnostic Radiology Physician
  • Albuquerque, NM
  • NPI 1114940228

  Diagnostic Radiology, NM

  Medicare reassignment Care Compare group NPD
• Charles Anthony Dow, MD

  • Vascular Surgery Physician
  • Las Cruces, NM
  • NPI 1437158003

  NM

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1171324800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1643068800000",
    "number": "1215079678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4000 MERIDIAN BLVD",
            "city": "FRANKLIN",
            "state": "TN",
            "postal_code": "370676325",
            "telephone_number": "615-465-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4351 E LOHMAN AVE",
            "address_2": "SUITE 200",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880118259",
            "telephone_number": "505-556-7737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAS CRUCES PHYSICIAN SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-13",
        "last_updated": "2022-01-25",
        "certification_date": "2022-01-25",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "SENIOR DIRECTOR, ENROLLMENT",
        "authorized_official_telephone_number": "877-892-9815"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Neurological Surgery",
            "state": "NM",
            "license": "2001-213",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": "NM",
            "license": "77-108",
            "primary": true
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "J0925",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Las Cruces Physician Practices, LLC
• Las Cruces Physician Practices, LLC
• Las Cruces Physician Practices, LLC
• Las Cruces Physician Practices, LLC
• Las Cruces Physician Practices, LLC
• Las Cruces Physician Services LLC
• Las Cruces Primary Care LLC
• Las Cruces Quickcare, LLC
• Las Cruces Radiology Associates Inc
• Las Cruces School District No. 2

• All providers in Las Cruces, NM
• Orthopaedic Surgery Physician in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.