Individual provider Active NPI

John Samuel Truitt, MD

  • Radiation Oncology Physician
  • Roswell, NM
National Provider Identifier
1295761898
Registry record updated Aug 17, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
86-136 Issued in NM
Practice address
405 W Country Club Rd
Roswell, NM 88201-5209
Phone
(575) 624-8738
Fax
(575) 624-8758
NPI assigned
Jun 24, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 17, 2016

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology Physician 2085R0001X 21749 AZ
Radiation Oncology Physician 2085R0001X J5501 TX
Radiation Oncology Physician 2085R0001X 86-136 NM Primary

Addresses

Primary practice location

405 W Country Club Rd
Roswell, NM 88201-5209

Mailing address

9787 Turkey Track
Hereford, AZ 85615
Phone (520) 378-4029

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
I20160922000759 NM Practitioner - Radiation Oncology 3870487911 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Radiation Oncology
Education
Medical College of Georgia School of Medicine, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

405 W Country Club Rd
Roswell, NM 88201-5209
Phone (520) 508-0754

Hospital & facility affiliations

  • Eastern New Mexico Medical Center Hospital, Roswell, NM, CCN 320006

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
21749AZMDRadiation Oncology Physician
J5501TXMDRadiation Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Truitt Radiation Oncology Services CurrentSince Jul 20, 2016 Accepting new patients
MD Med Inc Past Accepting new patients

Locations

2219 Dillon Rd
Clovis, NM 88101
Phone (505) 769-7365

405 W Country Club Rd
Roswell, NM 88201
Phone (505) 622-8170

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": "1151107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471392000000",
    "number": "1295761898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9787 TURKEY TRACK",
            "city": "HEREFORD",
            "state": "AZ",
            "postal_code": "85615",
            "telephone_number": "520-378-4029",
            "fax_number": "520-458-1001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 W COUNTRY CLUB RD",
            "city": "ROSWELL",
            "state": "NM",
            "postal_code": "882015209",
            "telephone_number": "575-624-8738",
            "fax_number": "575-624-8758"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRUITT",
        "first_name": "JOHN",
        "middle_name": "SAMUEL",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-24",
        "last_updated": "2016-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "AZ",
            "license": "21749",
            "primary": false
        },
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "TX",
            "license": "J5501",
            "primary": false
        },
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "NM",
            "license": "86-136",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roswell, NM

Sources for this page

Verify at the official NPI Registry.