Ruben Alfaro Supan, NP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

CNP-02362 Issued in NM

Practice address

405 W Country Club Rd
Roswell, NM 88201-5209

Phone

(505) 409-0831

NPI assigned

Feb 25, 2014

Last updated

Oct 27, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2013

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Hospital & facility affiliations

• Eastern New Mexico Medical Center Hospital, Roswell, NM, CCN 320006

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science, Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Priority Medical and Health Services LLC

  • Family Nurse Practitioner
  • Roswell, NM
  • NPI 1144956533

  Multi-Specialty

  Medicare reassignment NPD Authorized official
• Ruben a. Supan, LLC

  • Family Nurse Practitioner
  • Roswell, NM
  • NPI 1053802892
  Medicare reassignment Authorized official
• Alteon Health New Mexico LLC

  • Emergency Medicine Physician
  • Hobbs, NM
  • NPI 1457636706

  Multi-Specialty

  Medicare reassignment NPD
• State of New Mexico

  dba New Mexico State Veterans Home Physicians

  • Skilled Nursing Facility
  • Truth Or Consequences, NM
  • NPI 1578730230

  Multi-Specialty

  Medicare reassignment NPD
• State of New Mexico

  dba Department of Health Family Planning

  • Public Health or Welfare Agency
  • Santa Fe, NM
  • NPI 1134257249
  NPD
• State of New Mexico

  dba New Mexico Rehabilitation Center

  • Rehabilitation Hospital
  • Roswell, NM
  • NPI 1922094770

  Multi-Specialty

  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Roswell Hospital Corporation

  dba Eastern New Mexico Medical Center

  • General Acute Care Hospital
  • Roswell, NM
  • NPI 1447221742
  Care Compare affiliation

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

{
    "created_epoch": "1393286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698364800000",
    "number": "1619392883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8244",
            "city": "ROSWELL",
            "state": "NM",
            "postal_code": "882028244",
            "telephone_number": "575-624-2095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 W COUNTRY CLUB RD",
            "city": "ROSWELL",
            "state": "NM",
            "postal_code": "882015209",
            "telephone_number": "505-409-0831"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUPAN",
        "first_name": "RUBEN",
        "middle_name": "ALFARO",
        "name_prefix": "Mr.",
        "credential": "NP-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-02-25",
        "last_updated": "2023-10-27",
        "certification_date": "2023-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NM",
            "license": "CNP-02362",
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NM",
            "license": "CNP02032",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ramya Subgani, DDS
• Adalberto Subia-Juarez
• Stephanie Sugg
• Sun Country Physical Therapy
• Sunset Villa Healthcare LLC
• Jessie Marie Surla, DNP, BC- FNP
• Susanna Rand
• Joeanna Marie Talamantes, CST-CSFA
• Gim H Tan, MD
• Mindy Tanner, LMHC

• Family Nurse Practitioner in Roswell, NM
• Providers in Roswell, NM by specialty
• Family Nurse Practitioner in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.