Agape Anesthesia & Perioperative
Organization Active NPI Anesthesiology Physician · Las Cruces, NM
NPI 1689480667 · NPPES record last updated Feb 19, 2025
Key facts
- NPI
- 1689480667
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Anesthesiology Physician 207L00000X
- Legal business name
- AGAPE ANESTHESIA & PERIOPERATIVE
- Practice address
- 1205 S Telshor Blvd Ste a
Las Cruces, NM 88011-4748 - Phone
- (575) 222-0127
- Fax
- (575) 652-3255
- NPI assigned
- Dec 5, 2024
- Organization subpart
- No
Authorized official
- Name
- Jesse Holguin
- Title
- Administrator
- Phone
- (575) 222-0127
Practitioners 3
-
Krystal A. Franklin, M.D.
-
Diana P Levy, MSN, MBA, CRNA, APRN
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NM
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20250324000651 | NM | Part B Supplier - Clinic/Group Practice | 0941722144 |
Receives reassigned benefits from 3 practitioners Practice locations: Las Cruces, NM |
National Provider Directory
Locations
1205 S Telshor Blvd
Ste A
Las Cruces, NM 88011
Phone (575) 222-0127
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician |
207L00000X | Yes |
Addresses
Primary practice location
1205 S Telshor Blvd Ste a
Las Cruces, NM 88011-4748
Mailing address
1205 S Telshor Blvd
Las Cruces, NM 88011-4748
Phone (575) 222-0127
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All providers in Las Cruces, NM · Anesthesiology Physician in New Mexico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 19, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.