NPIMap

Individual provider Active NPI

Stephen J Otero, MD

  • Family Medicine Physician
  • Las Vegas, NV
National Provider Identifier
1720172109
Registry record updated Jun 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD2003-0049 Issued in NM
Practice address
10105 Banburry Cross Dr
Las Vegas, NV 89144-6646
Phone
(702) 877-5199
NPI assigned
Oct 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD2003-0049 NM Primary

Addresses

Primary practice location

10105 Banburry Cross Dr
Las Vegas, NV 89144-6646

Mailing address

PO Box 35380
Las Vegas, NV 89133-5380
Phone (702) 877-5199

Other practice location 1

129 El Paso Road
LCMC White Mountain Medical Associates
Ruidoso, NM 88345
Phone (575) 630-8350

Other identifiers 1

IdentifierTypeStateIssuer
17351235MedicaidNM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040716000672 NM Practitioner - Family Practice 2668460098 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of New Mexico School of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Presbyterian Healthcare ServicesGroup PAC ID 9234041708, 1,390 clinicians

Practice addresses (Care Compare)

211 Sudderth Dr
Ruidoso, NM 88345-6002
Phone (575) 630-4233

Hospital & facility affiliations

  • Enhabit Home Health Home health agency, Ruidoso, NM, CCN 327178
  • Lincoln County Medical Center Hospital, Ruidoso, NM, CCN 321306
  • Presbyterian Hospital Hospital, Albuquerque, NM, CCN 320021

Merit-based Incentive Payment System (MIPS)

Final score
88.68 of 100Reported as group
Quality
82.35
Promoting interoperability
100
Improvement activities
40
Cost
76.6

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0049NMMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Presbyterian Healthcare Services Family Medicine Current Accepting new patients
Presbyterian Healthcare Services CurrentSince Sep 12, 2005 Accepting new patients
Presbyterian Healthcare Services CurrentSince Sep 12, 2005 Accepting new patients
Santo Domingo Health Clinic Past Accepting new patients
Santa Clara Health Center PastSince Jan 19, 2012 Accepting new patients
San Felipe Health Clinic Past Accepting new patients
Presbyterian Healthcare Services Past Accepting new patients

Locations

2200 W 21st St
Clovis, NM 88101
Phone (505) 769-7577

129 El Paso Rd
Ruidoso, NM 88345
Phone (505) 257-6500

121 El Paso Rd
Ruidoso, NM 88345
Phone (505) 257-4061

211 Sudderth Dr
Ruidoso, NM 88345
Phone (505) 257-7381

Interoperability endpoints

  • Direct secure messaging: sotero13927@direct.phs.org

Organizations & group practices 7

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 4

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": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782432000000",
    "number": "1720172109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 35380",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891335380",
            "telephone_number": "702-877-5199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10105 BANBURRY CROSS DR",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891446646",
            "telephone_number": "702-877-5199"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "129 El Paso Road",
            "address_2": "LCMC WHITE MOUNTAIN MEDICAL ASSOCIATES",
            "address_purpose": "LOCATION",
            "city": "RUIDOSO",
            "state": "NM",
            "postal_code": "88345",
            "country_code": "US",
            "telephone_number": "575-630-8350",
            "fax_number": "575-257-4055",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OTERO",
        "first_name": "STEPHEN",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2026-06-26",
        "certification_date": "2026-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NM",
            "license": "MD2003-0049",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "17351235",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.