Individual provider Active NPI

Sarah Ethridge House, PA-C

  • Physician Assistant
  • Las Cruces, NM
National Provider Identifier
1750808333
Registry record updated Apr 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
2550 Samaritan Dr Ste 221
Las Cruces, NM 88001-1170
Phone
(575) 525-3535
NPI assigned
Aug 24, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 13, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician AssistantGroup: 193400000X SINGLE SPECIALTY GROUP 363A00000X Primary

Addresses

Primary practice location

2550 Samaritan Dr Ste 221
Las Cruces, NM 88001-1170

Mailing address

2550 Samaritan Dr Ste 221
Las Cruces, NM 88001-1170
Phone (575) 525-3535

Other names 1

  • Sarah Beth Ethridge Former name

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210727002413 NM Practitioner - Physician Assistant 9638445950 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Las Cruces Physician Services LLCGroup PAC ID 8224122759, 104 clinicians

Practice addresses (Care Compare)

1135 S Main St
Suite B
Las Cruces, NM 88005-2946
Phone (505) 525-4000

4301 E Lohman Ave
Las Cruces, NM 88011-8255

4311 E Lohman Ave
Las Cruces, NM 88011-8255

4351 E Lohman Ave
Las Cruces, NM 88011-8260

4371 E Lohman Ave
Las Cruces, NM 88011-8255
Phone (575) 522-7798

Hospital & facility affiliations

  • Mountain View Regional Medical Center Hospital, Las Cruces, NM, CCN 320085
  • Three Crosses Regional Hospital LLC Hospital, Las Cruces, NM, CCN 320091
  • Christus Southern New Mexico Hospital, Alamogordo, NM, CCN 320004
  • Sierra Vista Hospital Hospital, T Or C, NM, CCN 321300
  • Memorial Medical Center Hospital, Las Cruces, NM, CCN 320018

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Familycare Associates,PA Single Specialty Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: sarah.house.1@1928.direct.athenahealth.com

Organizations & group practices 2

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 5

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": "1503532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681344000000",
    "number": "1750808333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2550 SAMARITAN DR STE 221",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880011170",
            "telephone_number": "575-525-3535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2550 SAMARITAN DR STE 221",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880011170",
            "telephone_number": "575-525-3535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOUSE",
        "first_name": "SARAH",
        "middle_name": "ETHRIDGE",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-08-24",
        "last_updated": "2023-04-13",
        "certification_date": "2023-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SARAH",
            "last_name": "ETHRIDGE",
            "middle_name": "BETH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Las Cruces, NM

Sources for this page

Verify at the official NPI Registry.