Individual provider Active NPI

Gene Laurence Nathan, M.D.

  • Pediatrics Physician
  • Taos, NM
National Provider Identifier
1548417868
Registry record updated Jul 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
G36717 Issued in CA
Practice address
1331 Maestas Rd
Taos, NM 87571-6268
Phone
(575) 776-7806
Fax
(575) 224-3348
NPI assigned
Aug 19, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X G36717 CA Primary

Addresses

Primary practice location

1331 Maestas Rd
Taos, NM 87571-6268

Mailing address

1331 Maestas Rd
Taos, NM 87571-6268
Phone (575) 776-7806

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID, NM2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20200228000099 ID Practitioner - Pediatric Medicine 1951738137 Reassigns benefits to 1 organization
I20241112003775 NM Practitioner - Family Practice 1951738137 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Univ of Rochester School of Dental Medicine, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Taos Whole Health Integrative Care, LLC.Group PAC ID 0446523997, 6 clinicians

Practice addresses (Care Compare)

1331 Maestas Rd
Taos, NM 87571-6268
Phone (575) 776-7806

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G36717CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Teton Valley Health Care, Inc CurrentSince Jan 13, 2020 Accepting new patients
Taos Whole Health Integrative Care, LLC CurrentSince Sep 1, 2024 Accepting new patients
Teton Valley Health Care Inc Current Accepting new patients
Teton Valley Health Care, Inc Pediatrics CurrentSince Jan 13, 2020 Accepting new patients

Locations

120 E Howard St
Driggs, ID 83422
Phone (208) 354-2302

1331 Maestas Rd
Taos, NM 87571
Phone (505) 758-1216

Interoperability endpoints

  • Direct secure messaging: gene.nathan.1@17440.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/17440/brand/1/csg/1/fhir/r4

Organizations & group practices 4

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 2

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": "1219104000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783468800000",
    "number": "1548417868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1331 MAESTAS RD",
            "city": "TAOS",
            "state": "NM",
            "postal_code": "875716268",
            "telephone_number": "575-776-7806",
            "fax_number": "575-224-3348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1331 MAESTAS RD",
            "city": "TAOS",
            "state": "NM",
            "postal_code": "875716268",
            "telephone_number": "575-776-7806",
            "fax_number": "575-224-3348"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NATHAN",
        "first_name": "GENE",
        "middle_name": "LAURENCE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-08-19",
        "last_updated": "2026-07-08",
        "certification_date": "2026-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "G36717",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Taos, NM

Sources for this page

Verify at the official NPI Registry.