Active NPI
Arlan Lucero, CPSW
- Specialist
- Jemez Pueblo, NM
National Provider Identifier
1336704048
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 658
- Practice address
- 110 Sheep Springs
Jemez Pueblo, NM 87024 - Phone
- (575) 834-7413
- Fax
- (575) 834-3081
- NPI assigned
- May 8, 2019
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 658 | NM | Primary |
Addresses
Primary practice location
110 Sheep Springs
Jemez Pueblo, NM 87024
Mailing address
110 Sheep Springs
Jemez Pueblo, NM 87024
Phone (575) 834-7413
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 658 | NM | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1557273600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1592870400000",
"number": "1336704048",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "110 SHEEP SPRINGS",
"city": "JEMEZ PUEBLO",
"state": "NM",
"postal_code": "87024",
"telephone_number": "575-834-7413",
"fax_number": "575-834-3081"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "110 SHEEP SPRINGS",
"city": "JEMEZ PUEBLO",
"state": "NM",
"postal_code": "87024",
"telephone_number": "575-834-7413",
"fax_number": "575-834-3081"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LUCERO",
"first_name": "ARLAN",
"credential": "CPSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-05-08",
"last_updated": "2020-06-23",
"certification_date": "2020-06-23",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "NM",
"license": "658",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jemez Pueblo, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.