Individual provider Active NPI

Jon I Levin, DO

  • Surgery Physician
  • Taos, NM
National Provider Identifier
1396731899
Registry record updated Mar 23, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
A-926-91 Issued in NM
Practice address
1399 Weimer Rd
Suite # 600
Taos, NM 87571-6340
Phone
(575) 751-0334
Fax
(575) 751-0297
NPI assigned
Sep 21, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X A-926-91 NM Primary

Addresses

Primary practice location

1399 Weimer Rd
Suite # 600
Taos, NM 87571-6340

Mailing address

1399 Weimer Rd
Suite # 600
Taos, NM 87571-6340
Phone (575) 751-0334

Other identifiers 1

IdentifierTypeStateIssuer
11348824OtherCAQH

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
I20040217000970 NM Practitioner - General Surgery 3072408202

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

15 Grumman Rd W
Suite 1400
Bethpage, NY 11714-5029

2001 Lind Ave SW
Renton, WA 98057-3303

20555 Earl St
Torrance, CA 90503-3006

2215 Nashville Ave
Lubbock, TX 79410-1105

4400 NE Halsey St
Portland, OR 97213-1545

PO Box
Franklin, TN 37068-9022

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2381NMMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Covenant Medical Group CurrentSince Jan 1, 2021 Accepting new patients
Covenant Medical Group Surgery CurrentSince Jan 1, 2021 Accepting new patients
Jon I Levin DO PA Surgery PastSince Jan 1, 1992 Accepting new patients
Covenant Hospital Hobbs Past Accepting new patients
Taos Surgical Specialties LLC Past Accepting new patients
National Sinus Institute PLLC PastSince Apr 1, 2025 Accepting new patients

Locations

2000 W 21st St
Ste W7
Clovis, NM 88101
Phone (575) 637-7000

4900 N Lovington Hwy
Hobbs, NM 88240
Phone (575) 492-5000

5419 N Lovington Hwy
Ste 4
Hobbs, NM 88240
Phone (505) 392-7537

2215 Nashville Ave
Lubbock, TX 79410
Phone (806) 725-5228

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/HDAHAA
  • Direct secure messaging: jlevin2018563@oc.providencedirect.org
  • FHIR API: https://api.platform.athenahealth.com/2508/brand/3/csg/1/fhir/r4

Organizations & group practices 6

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": "1127260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1237766400000",
    "number": "1396731899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1399 WEIMER RD",
            "address_2": "SUITE # 600",
            "city": "TAOS",
            "state": "NM",
            "postal_code": "875716340",
            "telephone_number": "575-751-0334",
            "fax_number": "575-751-0297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1399 WEIMER RD",
            "address_2": "SUITE # 600",
            "city": "TAOS",
            "state": "NM",
            "postal_code": "875716340",
            "telephone_number": "575-751-0334",
            "fax_number": "575-751-0297"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEVIN",
        "first_name": "JON",
        "middle_name": "I",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-21",
        "last_updated": "2009-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NM",
            "license": "A-926-91",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11348824",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Taos, NM

Sources for this page

Verify at the official NPI Registry.