Jeanette Lara, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

A-2410-20 Issued in NM

Practice address

204 Angelina Blvd
Chaparral, NM 88081-7558

Phone

(758) 248-1005

Fax

(575) 824-8101

NPI assigned

Jun 5, 2017

Last updated

Dec 11, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

At Still University of Health Sciences, College of Osteo Med, Kirksville, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Presbyterian Medical ServicesGroup PAC ID 2062324684, 132 clinicians

Otero County Hospital AssociationGroup PAC ID 3173516606, 245 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Christus Southern New Mexico Hospital, Alamogordo, NM, CCN 320004

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jeanette.lara.1@6965.direct.athenahealth.com
• Direct secure messaging: jeanette.larado.p1@direct.pmsnm.nextgenshare.com

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.

• Otero County Hospital Association

  dba CHRISTUS Southern New Mexico

  • General Acute Care Hospital
  • Alamogordo, NM
  • NPI 1861450579

  Multi-Specialty

  Medicare reassignment Care Compare group NPD
• Presbyterian Medical Services

  dba Rio Rancho Family Health Center

  • Federally Qualified Health Center (FQHC)
  • Rio Rancho, NM
  • NPI 1871505032

  Multi-Specialty

  Medicare reassignment Care Compare group NPD
• Otero County Hospital Association

  dba CHRISTUS Pharmacy (Downtown)

  • Community/Retail Pharmacy
  • Alamogordo, NM
  • NPI 1235948803
  NPD
• Presbyterian Medical Services

  dba PMS Central Pharmacy

  • Community/Retail Pharmacy
  • Albuquerque, NM
  • NPI 1306654462
  NPD
• Presbyterian Medical Services

  dba PMS-Socorro Mental Health

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Socorro, NM
  • NPI 1760805303
  NPD
• Presbyterian Medical Services

  • Federally Qualified Health Center (FQHC)
  • Santa Fe, NM
  • NPI 1518910553

  Multi-Specialty

  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Otero County Hospital Association

  dba CHRISTUS Southern New Mexico

  • General Acute Care Hospital
  • Alamogordo, NM
  • NPI 1861450579
  Care Compare affiliation

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

{
    "created_epoch": "1496620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607644800000",
    "number": "1265961114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 ANGELINA BLVD",
            "city": "CHAPARRAL",
            "state": "NM",
            "postal_code": "880817558",
            "telephone_number": "758-248-1005",
            "fax_number": "575-824-8101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 ANGELINA BLVD",
            "city": "CHAPARRAL",
            "state": "NM",
            "postal_code": "880817558",
            "telephone_number": "758-248-1005",
            "fax_number": "575-824-8101"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2450 S Telshor Blvd",
            "address_purpose": "LOCATION",
            "city": "Las Cruces",
            "state": "NM",
            "postal_code": "880115141",
            "country_code": "US",
            "telephone_number": "575-521-5385",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LARA",
        "first_name": "JEANETTE",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-06-05",
        "last_updated": "2020-12-11",
        "certification_date": "2020-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NM",
            "license": "R-25-2017",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NM",
            "license": "A-2410-20",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• La Clinica de Familia, Incorporated
• La Clinica de Familia, Incorporated
• La Clinica de Familia, Incorporated (La Clinica De Familia Chaparral Medical)
• La Clinica de Familia, Incorporated (La Clinica De Familia Chaparral Dental)
• La Clinica de Familia, Incorporated (Chaparral School Base)
• Guadalupe Lerma, CHW
• Lessons From Horses, Inc.
• Ruth Lozano
• Tanya Sue Maestas, DDS
• Manabat LLC

• Family Medicine Physician in Chaparral, NM
• Providers in Chaparral, NM by specialty
• Family Medicine Physician in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2020; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.