Active NPI
Ruben Costales Nanez, MT ASCP
- Medical Technologist
- Las Cruces, NM
National Provider Identifier
1629600556
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Technologist
- License
- MT175482
- Practice address
- 661 Wendy LN
Las Cruces, NM 88007-5324 - Phone
- (575) 649-1847
- NPI assigned
- Feb 9, 2020
- 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 |
|---|---|---|---|---|
| Medical Technologist | 246QM0706X | MT175482 | NM | Primary |
Addresses
Primary practice location
661 Wendy LN
Las Cruces, NM 88007-5324
Mailing address
661 Wendy LN
Las Cruces, NM 88007-5324
Phone (575) 649-1847
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
- Credentials
- Medical Technician
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MT175482 | NM | MD | Medical Technologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1581206400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1581206400000",
"number": "1629600556",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "661 WENDY LN",
"city": "LAS CRUCES",
"state": "NM",
"postal_code": "880075324",
"telephone_number": "575-649-1847"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "661 WENDY LN",
"city": "LAS CRUCES",
"state": "NM",
"postal_code": "880075324",
"telephone_number": "575-649-1847"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NANEZ",
"first_name": "RUBEN",
"middle_name": "COSTALES",
"credential": "MT ASCP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-02-09",
"last_updated": "2020-02-09",
"certification_date": "2020-02-09",
"status": "A"
},
"taxonomies": [
{
"code": "246QM0706X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Pathology, Medical Technologist",
"state": "NM",
"license": "MT175482",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Las Cruces, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 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.