NPIMap

Organization Active NPI

Wellmed Medical Group, P.a.

Doing business as WellMed at Telshor

  • Family Medicine Physician
  • Las Cruces, NM
National Provider Identifier
1659679157
Registry record updated Dec 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
WELLMED MEDICAL GROUP, P.A.
Doing business as
WellMed at Telshor
Practice address
530 N Telshor Blvd Ste C
Las Cruces, NM 88011-8243
Phone
(575) 323-6500
NPI assigned
Mar 8, 2011
Last updated
Dec 19, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2019

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

Authorized official

Name
Dr. Carlos O Hernandez, M.D.
Title
President
Phone
(210) 877-7570

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary
Internal Medicine Physician 207R00000X NU

Addresses

Primary practice location

530 N Telshor Blvd Ste C
Las Cruces, NM 88011-8243

Mailing address

8637 Fredericksburg Rd Ste 360
Attn: Director of Accounts Receivable
San Antonio, TX 78240-1285
Phone (210) 877-7570

Other names 1

  • WellMed at Telshor Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20041105000519 TX Part B Supplier - Clinic/Group Practice 4880657386 Receives reassigned benefits from 880 practitioners
9 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
O20160208000962 NM Part B Supplier - Clinic/Group Practice 4880657386 Receives reassigned benefits from 3 practitioners
Practice locations: Las Cruces, NM

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 9

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

5460 Paredes Line Rd
Ste 200
Brownsville, TX 78526
Phone (956) 554-0010

1030 Bensdale Rd
Pleasanton, TX 78064
Phone (830) 569-6615

Practitioners & affiliated clinicians

Practitioners 51

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 51

NPI Registry JSON

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

{
    "created_epoch": "1299542400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1576713600000",
    "number": "1659679157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8637 FREDERICKSBURG RD STE 360",
            "address_2": "ATTN: DIRECTOR OF ACCOUNTS RECEIVABLE",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782401285",
            "telephone_number": "210-877-7570",
            "fax_number": "210-641-2235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 N TELSHOR BLVD STE C",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880118243",
            "telephone_number": "575-323-6500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLMED MEDICAL GROUP, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-08",
        "last_updated": "2019-12-19",
        "certification_date": "2019-12-19",
        "status": "A",
        "authorized_official_last_name": "HERNANDEZ",
        "authorized_official_first_name": "CARLOS",
        "authorized_official_middle_name": "O",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "210-877-7570",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WellMed at Telshor",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Dec 19, 2019; 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.