Individual provider Active NPI

Osvaldo Rene Delavega, MD

  • Nephrology Physician
  • Las Cruces, NM
National Provider Identifier
1669548848
Registry record updated Aug 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
90-31 Issued in NM
Practice address
755 S Telshor Blvd
Suite S101
Las Cruces, NM 88011-4688
Phone
(575) 521-1575
Fax
(575) 521-1940
NPI assigned
Nov 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 90-31 NM Primary

Addresses

Primary practice location

755 S Telshor Blvd
Suite S101
Las Cruces, NM 88011-4688

Mailing address

755 S Telshor Blvd
Suite S101
Las Cruces, NM 88011-4688
Phone (575) 521-1575

Other identifiers 1

IdentifierTypeStateIssuer
23580MedicaidNM

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
I20050720000028 NM Practitioner - Internal MedicinePractitioner - Nephrology 2961438668 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Nephrology
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

755 S Telshor Blvd
Suite S101
Las Cruces, NM 88011-4688
Phone (575) 556-9426

Hospital & facility affiliations

  • 322516 Deming Dialysis (FMC) Dialysis facility, Deming, NM, CCN 322516
  • 322528 Las Cruces South Dialysis (FMC) Dialysis facility, Las Cruces, NM, CCN 322528
  • 322505 Las Cruces Dialysis (FMC) Dialysis facility, Las Cruces, NM, CCN 322505
  • Memorial Medical Center Hospital, Las Cruces, NM, CCN 320018
  • Mountain View Regional Medical Center Hospital, Las Cruces, NM, CCN 320085
  • Mimbres Valley Medical Center Hospital, Deming, NM, CCN 321309
  • Sierra Vista Hospital Hospital, T Or C, NM, CCN 321300
  • Christus Southern New Mexico Hospital, Alamogordo, NM, CCN 320004

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
90-31NMMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kidney Wellness Center LC Nephrology CurrentSince Oct 1, 2022 Accepting new patients

Locations

755 S Telshor Blvd
Ste S101
Las Cruces, NM 88011
Phone (575) 521-1575

755 S Telshor Blvd
Ste 101
Las Cruces, NM 88011
Phone (575) 222-4355

Organizations & group practices 1

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 8

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": "1164672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470614400000",
    "number": "1669548848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "755 S TELSHOR BLVD",
            "address_2": "SUITE S101",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880114688",
            "telephone_number": "575-521-1575",
            "fax_number": "575-521-1940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "755 S TELSHOR BLVD",
            "address_2": "SUITE S101",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880114688",
            "telephone_number": "575-521-1575",
            "fax_number": "575-521-1940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELAVEGA",
        "first_name": "OSVALDO",
        "middle_name": "RENE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-28",
        "last_updated": "2016-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "NM",
            "license": "90-31",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "23580",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Cruces, NM

Sources for this page

Verify at the official NPI Registry.