NPIMap

Organization Active NPI

Alteon Health New Mexico LLC

  • Emergency Medicine Physician
  • Hobbs, NM
National Provider Identifier
1457636706
Registry record updated Feb 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
ALTEON HEALTH NEW MEXICO LLC
Practice address
5419 N Lovington Hwy
Hobbs, NM 88240-9100
Phone
(844) 474-4019
NPI assigned
Oct 19, 2011
Last updated
Feb 24, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2023

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

Authorized official

Name
Melissa Reese
Title
Provider Enrollment Officer
Phone
(855) 687-0618

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207P00000X Primary
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X

Addresses

Primary practice location

5419 N Lovington Hwy
Hobbs, NM 88240-9100

Mailing address

4535 Dressler Rd NW
Canton, OH 44718-2545
Phone (330) 994-4409

Other identifiers 1

IdentifierTypeStateIssuer
58674853MedicaidNM

Other names 2

  • Island Medical LOE LLC Former legal business name
  • Pegasus Emergency Group LOE LLC Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120113000095 NM Part B Supplier - Clinic/Group Practice 3274700323 Receives reassigned benefits from 77 practitioners
Practice locations: Carlsbad, NM; Hobbs, NM; Roswell, NM

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 95

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 95

NPI Registry JSON

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

{
    "created_epoch": "1318982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1677196800000",
    "number": "1457636706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4535 DRESSLER RD NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447182545",
            "telephone_number": "330-994-4409",
            "fax_number": "330-492-8489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5419 N LOVINGTON HWY",
            "city": "HOBBS",
            "state": "NM",
            "postal_code": "882409100",
            "telephone_number": "844-474-4019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALTEON HEALTH NEW MEXICO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-19",
        "last_updated": "2023-02-24",
        "certification_date": "2023-02-24",
        "status": "A",
        "authorized_official_last_name": "REESE",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_title_or_position": "PROVIDER ENROLLMENT OFFICER",
        "authorized_official_telephone_number": "855-687-0618"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "58674853",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Island Medical LOE LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Pegasus Emergency Group LOE LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Hobbs, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.