Jacob Alexander, DO, MPH
Individual provider Active NPI Public Health & General Preventive Medicine Physician · Dulce, NM
NPI 1780003442 · NPPES record last updated Sep 15, 2025
Key facts
- NPI
- 1780003442
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Public Health & General Preventive Medicine Physician 2083P0901X
- License
- DR.0057889 (CO)
- Practice address
- 500 N. Mundo
Dulce, NM 87528 - Phone
- (575) 759-3291
- Fax
- (575) 759-7294
- NPI assigned
- Apr 9, 2014
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 11
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Preventive Medicine
- Education
- Lake Erie College of Osteopathic Medicine, Bradenton, 2014
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- San Juan Regional Medical Center, Inc.
Practice addresses (Care Compare)
4820 E Main St
2 Sjrmc Urgent Care
Farmington, NM 87402-8660
Phone (505) 609-6495
Hospital & facility affiliations
- San Juan Regional Medical Center Inc
Merit-based Incentive Payment System (MIPS)
- Final score
- 95.74 of 100
- Quality
- 92.26
- Promoting interoperability
- 100
- Improvement activities
- 40
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (3 enrollments) in CO, TX, NM
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170405002192 | CO | Practitioner - Preventive Medicine |
0345526364 | Reassigns benefits to 1 organization |
| I20180801000375 | TX | Practitioner - Preventive Medicine | 0345526364 | Reassigns benefits to 1 organization |
| I20250927000511 | NM | Practitioner - Preventive Medicine | 0345526364 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy, Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DR.0057889 | CO | MD | Public Health & General Preventive Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Jicarilla IHS Pharmacy | Current |
Accepting new patients | |
| San Juan Regional Medical Center Inc | Current | Accepting new patients | |
| The Pagosa Medical Group LLC | Current |
Accepting new patients | |
| San Juan Regional Medical Center Inc | Current |
Accepting new patients | |
| San Juan Regional Medical Center Inc | Current |
Accepting new patients | |
| San Juan Regional Medical Center Inc | Past | Accepting new patients | |
| San Juan Regional Medical Center Inc | Past | Accepting new patients |
Locations
27B Talisman Dr
Unit 3
Pagosa Springs, CO 81147
Phone (970) 372-0456
4820 E Main St
Ste 2
Farmington, NM 87402
Phone (505) 609-6610
4820 E Main St
Farmington, NM 87402
Phone (505) 326-0459
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Public Health & General Preventive Medicine Physician | 2083P0901X | DR.0057889 | CO | Yes |
| Public Health & General Preventive Medicine Physician | 2083P0901X | DO2025-0114 | NM |
Addresses
Primary practice location
500 N. Mundo
Dulce, NM 87528
Mailing address
PO Box 187
Dulce, NM 87528-0187
Phone (575) 759-3291
Other practice location 1
4820 E Main St
Farmington, NM 87402-8660
Phone (505) 609-6495
Other providers in Dulce, NM
All providers in Dulce, NM · Public Health & General Preventive Medicine 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 Sep 15, 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.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.