Kevin Jay Regan, PA C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

PA20030004 Issued in NM

Practice address

5400 Gibson SE
Lovelace Medical Center
Albuquerque, NM 87108

Phone

(505) 262-7000

NPI assigned

Sep 28, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Southwest Medical Associates, LLC

  • General Practice Physician
  • Albuquerque, NM
  • NPI 1164491072
  Medicare reassignment NPD
• Optumcare Endoscopy Center New Mexico, LLC

  • Ambulatory Surgical Clinic/Center
  • Albuquerque, NM
  • NPI 1962685834
  NPD (past)

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

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1265524177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 27829",
            "address_2": "LOVELACE MEDICAL GROUP",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "87125",
            "telephone_number": "505-262-7026",
            "fax_number": "505-727-9276"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5400 GIBSON SE",
            "address_2": "LOVELACE MEDICAL CENTER",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "87108",
            "telephone_number": "505-262-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REGAN",
        "first_name": "KEVIN",
        "middle_name": "JAY",
        "credential": "PA C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NM",
            "license": "PA20030004",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Reform Spine & Injury Care Center
• Refreshed Beauty, LLC
• Refugee and Immigrant Wellness Center LLC
• Darcie Brielle Regalado
• Zalma Sarai Regalado
• Mark Regan
• Carl J Regensberg, LADAC
• Melissa Regensberg, RN
• Regenx Care LLC
• Angelica Regino, LCSW

• Surgical Physician Assistant in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Surgical Physician Assistant in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.