Individual provider Active NPI

Saber Kamel M Jan, MBBS, MPH

  • Pediatrics Physician
  • Las Cruces, NM
National Provider Identifier
1629695762
Registry record updated Jul 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD2023-0190 Issued in NM
Practice address
4401 E Lohman Ave
Las Cruces, NM 88011-8267
Phone
(575) 532-9077
NPI assigned
Jul 5, 2020
Last updated
Jul 17, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2023

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 MD2023-0190 NM Primary

Addresses

Primary practice location

4401 E Lohman Ave
Las Cruces, NM 88011-8267

Mailing address

4260 Northrise Dr Apt 1722
Las Cruces, NM 88011-7317
Phone (315) 480-1038

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
I20230809002271 NM Practitioner - Pediatric Medicine 8022470939 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD2023-0190NMMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Las Cruces Physician Services LLC CurrentSince Sep 1, 2023 Accepting new patients
Las Cruces Medical Center LLC Past Accepting new patients
Familycare Associates,PA Past Accepting new patients

Locations

1135 S Main St
Ste B
Las Cruces, NM 88005
Phone (505) 522-5205

4351 E Lohman Ave
Ste 201
Las Cruces, NM 88011
Phone (575) 522-2233

Interoperability endpoints

  • Direct secure messaging: jan.saber.1@1928.direct.athenahealth.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1593907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689552000000",
    "number": "1629695762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4260 NORTHRISE DR APT 1722",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880117317",
            "telephone_number": "315-480-1038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4401 E LOHMAN AVE",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880118267",
            "telephone_number": "575-532-9077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAN",
        "first_name": "SABER",
        "middle_name": "KAMEL M",
        "name_prefix": "Dr.",
        "credential": "MBBS, MPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-07-05",
        "last_updated": "2023-07-17",
        "certification_date": "2023-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NM",
            "license": "MD2023-0190",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Cruces, NM

Sources for this page

Verify at the official NPI Registry.