Individual provider Active NPI

Kanaka Lakshmy Chelliah, M.D

  • Family Medicine Physician
  • Las Cruces, NM
National Provider Identifier
1295910321
Registry record updated Nov 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD2010-0227 Issued in NM
Practice address
4500 N Sonoma Ranch Blvd
Las Cruces, NM 88011-7334
Phone
(575) 652-4048
Fax
(575) 556-9766
NPI assigned
Jan 8, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 15, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD2010-0227 NM Primary

Addresses

Primary practice location

4500 N Sonoma Ranch Blvd
Las Cruces, NM 88011-7334

Mailing address

4500 N Sonoma Ranch Blvd
Las Cruces, NM 88011-7334
Phone (575) 652-4048

Other identifiers 1

IdentifierTypeStateIssuer
01422081MedicaidNM

Other names 1

  • Kanaka L Chelliah Professional name

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
I20100914001352 NM Practitioner - Family Practice 0446375455 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

4500 N Sonoma Ranch Blvd
Las Cruces, NM 88011-7334
Phone (575) 652-4048

Hospital & facility affiliations

  • Tender Care Home Health Home health agency, Las Cruces, NM, CCN 327208
  • Memorial Medical Center Hospital, Las Cruces, NM, CCN 320018
  • Three Crosses Regional Hospital LLC Hospital, Las Cruces, NM, CCN 320091
  • Mountain View Regional Medical Center Hospital, Las Cruces, NM, CCN 320085

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD2010-0227NMMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Telshor Family Clinic LLC Family Medicine CurrentSince Aug 19, 2011 Accepting new patients
Familycare Associates,PA Family Medicine Past Accepting new patients

Locations

4500 N Sonoma Ranch Blvd
Las Cruces, NM 88011
Phone (575) 652-4048

2901 Hillrise Dr
Las Cruces, NM 88011
Phone (505) 532-1213

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 4

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": "1199750400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731628800000",
    "number": "1295910321",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4500 N SONOMA RANCH BLVD",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880117334",
            "telephone_number": "575-652-4048",
            "fax_number": "575-556-9766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 N SONOMA RANCH BLVD",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880117334",
            "telephone_number": "575-652-4048",
            "fax_number": "575-556-9766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHELLIAH",
        "first_name": "KANAKA LAKSHMY",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-01-08",
        "last_updated": "2024-11-15",
        "certification_date": "2024-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NM",
            "license": "MD2010-0227",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01422081",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KANAKA",
            "last_name": "CHELLIAH",
            "middle_name": "L",
            "credential": "M.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Las Cruces, NM

Sources for this page

Verify at the official NPI Registry.