Daniel Xethan Haire, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

2019044493 Issued in MO

Practice address

500 N Mundo
Dulce, NM 87528-0187

Phone

(575) 759-3291

Fax

(575) 759-3651

NPI assigned

Apr 10, 2017

Last updated

Jul 21, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

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

Specialty

Family Practice

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Dulce Health CenterGroup PAC ID 7012991839, 4 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Pagosa Springs Medical Center Hospital, Pagosa Springs, CO, CCN 061328
• San Juan Regional Medical Center Inc Hospital, Farmington, NM, CCN 320005

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Dulce Health Center

  • General Acute Care Hospital
  • Dulce, NM
  • NPI 1750388963

  TX

  Medicare reassignment Care Compare group
• Jicarilla IHS Pharmacy

  dba Dulce IHS Pharmacy

  • Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
  • Dulce, NM
  • NPI 1124220900
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• San Juan Regional Medical Center Inc

  dba SJRMC Inpatient Rehab Unit

  • Rehabilitation Hospital Unit
  • Farmington, NM
  • NPI 1326663592
  Care Compare affiliation
• San Juan Regional Medical Center, Inc.

  • General Acute Care Hospital
  • Farmington, NM
  • NPI 1427058510
  Care Compare affiliation
• Upper San Juan Health Service District

  dba Pagosa Springs Medical Center

  • Critical Access Hospital
  • Pagosa Springs, CO
  • NPI 1245401561
  Care Compare affiliation

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

{
    "created_epoch": "1491782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595289600000",
    "number": "1750814323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 187",
            "city": "DULCE",
            "state": "NM",
            "postal_code": "875280187",
            "telephone_number": "575-759-3291",
            "fax_number": "575-759-3651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 N MUNDO",
            "city": "DULCE",
            "state": "NM",
            "postal_code": "875280187",
            "telephone_number": "575-759-3291",
            "fax_number": "575-759-3651"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6675 Holmes Rd",
            "address_2": "#360",
            "address_purpose": "LOCATION",
            "city": "Kansas City",
            "state": "MO",
            "postal_code": "641311150",
            "country_code": "US",
            "telephone_number": "816-276-7600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAIRE",
        "first_name": "DANIEL",
        "middle_name": "XETHAN",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-10",
        "last_updated": "2020-07-21",
        "certification_date": "2020-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "2019044493",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Margaret Jean Gillean, RN
• Michael W Goldberg, M.A.
• Yolandra Gomez, MD
• Sharon Hope Greacen, MT(ASCP)
• Steven Paul Gross, M.D.
• Patrick S Hogan, RPH
• Diane P Holzem, RN,C
• Indian Health Service- Jicarilla Service Unit
• Deanna S Iovine, RN
• Jicarilla Apache Health Care Facility

• Family Medicine Physician in Dulce, NM
• Providers in Dulce, NM by specialty
• Family Medicine Physician in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.