Individual provider Active NPI

Philip Owen, MD

  • Anesthesiology Physician
  • Las Cruces, NM
National Provider Identifier
1255309142
Registry record updated Jul 28, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
94-115 Issued in NM
Practice address
205 W. Boutz Rd. BLDG #1
Las Cruces, NM 88005
Phone
(575) 532-7000
Fax
(575) 556-7131
NPI assigned
Mar 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 94-115 NM Primary

Addresses

Primary practice location

205 W. Boutz Rd. BLDG #1
Las Cruces, NM 88005

Mailing address

205 W. Boutz Rd. BLDG #1
Las Cruces, NM 88005
Phone (575) 532-7000

Other identifiers 1

IdentifierTypeStateIssuer
W6124MedicaidNM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM, TX2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20100625000564 NM Practitioner - Anesthesiology 6002894383 Reassigns benefits to 1 organization
I20150806011310 TX Practitioner - Anesthesiology 6002894383 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
University of New Mexico School of Medicine, 1990
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

150 Civic Ctr Dr
Suite 200
Sandy, UT 84070-4284

205 W Boutz Rd
BLDG 1
Las Cruces, NM 88005-3259

PO Box
Suite 680060
Franklin, TN 37068-0060

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Main Street Anesthesia of New Mexico, LLC Anesthesiology CurrentSince Nov 1, 2019 Accepting new patients
Anesthesia Associates of El Paso PA Anesthesiology CurrentSince Jul 15, 2015 Accepting new patients

Locations

1205 S Telshor Blvd
Las Cruces, NM 88011
Phone (505) 260-4300

4311 E Lohman Ave
Las Cruces, NM 88011
Phone (505) 556-6800

2450 S Telshor Blvd
Las Cruces, NM 88011
Phone (505) 522-8641

117 E 19th St
Roswell, NM 88201
Phone (505) 727-2000

4815 Alameda Ave
El Paso, TX 79905
Phone (915) 215-6000

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.

Hospital & facility affiliations 1

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": "1141776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280275200000",
    "number": "1255309142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 W. BOUTZ RD. BLDG #1",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "88005",
            "telephone_number": "575-532-7000",
            "fax_number": "575-556-7131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 W. BOUTZ RD. BLDG #1",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "88005",
            "telephone_number": "575-532-7000",
            "fax_number": "575-556-7131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OWEN",
        "first_name": "PHILIP",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-08",
        "last_updated": "2010-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NM",
            "license": "94-115",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "W6124",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Cruces, NM

Sources for this page

Verify at the official NPI Registry.