Fernando J Indacochea, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

MD2012-0871 Issued in NM

Practice address

4401 E. Lohman Ave.
Suite a
Las Cruces, NM 88011

Phone

(575) 532-9077

Fax

(575) 532-9221

NPI assigned

Aug 3, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: f.indacochea@rgmgl-nm.direct.office.nextgen.com
• Direct secure messaging: fernando.indacochea.2@1928.direct.athenahealth.com

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.

• Las Cruces Physician Services LLC

  • Orthopaedic Surgery Physician
  • Las Cruces, NM
  • NPI 1215079678
  Medicare reassignment NPD
• Familycare Associates,PA

  • Family Medicine Physician
  • Las Cruces, NM
  • NPI 1821161407
  NPD (past)
• Las Cruces Medical Center LLC

  • General Acute Care Hospital
  • Las Cruces, NM
  • NPI 1205882503
  NPD (past)

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

{
    "created_epoch": "1123027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600732800000",
    "number": "1720089519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4395 ISLETA CT",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880114297",
            "telephone_number": "304-902-0443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4401 E. LOHMAN AVE.",
            "address_2": "SUITE A",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "88011",
            "telephone_number": "575-532-9077",
            "fax_number": "575-532-9221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "INDACOCHEA",
        "first_name": "FERNANDO",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-03",
        "last_updated": "2020-09-22",
        "certification_date": "2020-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NM",
            "license": "MD2012-0871",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0107734000",
            "state": "WV"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "fernando.indacochea.2@1928.direct.athenahealth.com",
            "affiliation": "N",
            "endpointDescription": "AMR Direct address",
            "address_1": "4401 E. Lohman Ave.",
            "address_2": "Suite A",
            "city": "Las Cruces",
            "state": "NM",
            "country_code": "US",
            "postal_code": "88011",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Maria Jose Iglesias-Corral
• Claudia Isela Iglesias
• Victor Lee Ilog, FNP
• Imad Idriss MD PA
• Mia Impastato
• Indian Wells Ultrasound Imaging Inc
• Inetmed RX2 Inc.
• Inetmed RX2 Inc.
• Maria A Infante-Rubio, MA., CCC-SLP
• Elma Teresa Infante, RN

• Pediatrics Physician in Las Cruces, NM
• Providers in Las Cruces, NM by specialty
• Pediatrics Physician in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.