Individual provider Active NPI

Fernando Ravessoud, M.D.

  • Orthopaedic Surgery Physician
  • Las Cruces, NM
National Provider Identifier
1235125634
Registry record updated Nov 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
MD2011-0758 Issued in NM
Practice address
880 S Telshor Blvd Ste 201
Las Cruces, NM 88011-8682
Phone
(575) 222-0037
Fax
(575) 571-4592
NPI assigned
Sep 21, 2005
Reactivated
Apr 12, 2006
Last updated
Nov 18, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X MD2011-0758 NM Primary

Addresses

Primary practice location

880 S Telshor Blvd Ste 201
Las Cruces, NM 88011-8682

Mailing address

880 S Telshor Blvd Ste 200
Las Cruces, NM 88011-8601
Phone (575) 222-0037

Other practice location 1

2530 S Telshor Blvd
Suite 201
Las Cruces, NM 88011-4951
Phone (575) 556-6440

Other identifiers 1

IdentifierTypeStateIssuer
95425578MedicaidNM

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
I20111219000651 NM Practitioner - Orthopedic Surgery 5496799694 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD2011-0758NMMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Las Cruces Physician Practices, LLC Current Accepting new patients
Las Cruces Physician Practices, LLC CurrentSince Dec 1, 2011 Accepting new patients
Las Cruces Physician Practices, LLC Orthopaedic Surgery CurrentSince Dec 1, 2011 Accepting new patients
Ravessoud Orthopedics and Spine, PC CurrentSince Sep 1, 2021 Accepting new patients
Fernando Ravessoud, M.D. Inc. Orthopaedic Surgery PastSince Sep 15, 1998 Accepting new patients

Locations

2530 S Telshor Blvd
Ste 201
Las Cruces, NM 88011
Phone (505) 521-1554

4351 E Lohman Ave
Ste 200
Las Cruces, NM 88011
Phone (505) 532-9755

4351 E Lohman Ave
Ste 403
Las Cruces, NM 88011
Phone (575) 522-6806

880 S Telshor Blvd
Ste 200
Las Cruces, NM 88011
Phone (575) 222-0037

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1127260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668729600000",
    "number": "1235125634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "880 S TELSHOR BLVD STE 200",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880118601",
            "telephone_number": "575-222-0037",
            "fax_number": "575-571-4592"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "880 S TELSHOR BLVD STE 201",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880118682",
            "telephone_number": "575-222-0037",
            "fax_number": "575-571-4592"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2530 S Telshor Blvd",
            "address_2": "Suite 201",
            "address_purpose": "LOCATION",
            "city": "Las Cruces",
            "state": "NM",
            "postal_code": "880114951",
            "country_code": "US",
            "telephone_number": "575-556-6440",
            "fax_number": "575-556-6445",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RAVESSOUD",
        "first_name": "FERNANDO",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-21",
        "last_updated": "2022-11-18",
        "certification_date": "2022-11-18",
        "deactivation_date": "2006-03-24",
        "reactivation_date": "2006-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NM",
            "license": "MD2011-0758",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "95425578",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Cruces, NM

Sources for this page

Verify at the official NPI Registry.