NPIMap

Individual provider Active NPI

Spencer Terence Debauche

  • Hospitalist Physician
  • Farmington, NM
National Provider Identifier
1780143818
Registry record updated Nov 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
DO2022-0036 Issued in NM
Practice address
801 W Maple St
Farmington, NM 87401-5630
Phone
(505) 609-2000
NPI assigned
Mar 18, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 14, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X DO2022-0036 NM Primary
Student in an Organized Health Care Education/Training ProgramGroup: 193200000X MULTI-SPECIALTY GROUP 390200000X

Addresses

Primary practice location

801 W Maple St
Farmington, NM 87401-5630

Mailing address

PO Box 844088
Dallas, TX 75284-4088
Phone (505) 609-2258

Other practice location 1

1800 SE Tiffany Ave
Port St Lucie, FL 34952-7521
Phone (772) 398-3623

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
I20220825002095 NM Practitioner - Hospitalist 0446687099 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hospitalist
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

4820 E Main St
Farmington, NM 87402-8660

801 W Maple St
Farmington, NM 87401-5630

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.97 of 100Reported as group
Quality
79.73
Promoting interoperability
100
Improvement activities
40
Cost
78.87

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DO2022-0036NMMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
San Juan Regional Medical Center Inc Multi-Specialty CurrentSince Aug 8, 2022 Accepting new patients
San Juan Regional Medical Center Inc Multi-Specialty Current Accepting new patients
San Juan Regional Medical Center Inc Multi-Specialty CurrentSince Aug 8, 2022 Accepting new patients
San Juan Regional Medical Center, Inc. Past Accepting new patients

Locations

801 W Maple St
Farmington, NM 87401
Phone (505) 325-5011

4820 E Main St
Ste 2
Farmington, NM 87402
Phone (505) 609-6610

Interoperability endpoints

  • Direct secure messaging: spencer.debauche@hca4.eclinicaldirectplus.com

Organizations & group practices 4

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 8

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": "1552867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731542400000",
    "number": "1780143818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 844088",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752844088",
            "telephone_number": "505-609-2258",
            "fax_number": "505-609-2259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 W MAPLE ST",
            "city": "FARMINGTON",
            "state": "NM",
            "postal_code": "874015630",
            "telephone_number": "505-609-2000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1800 SE Tiffany Ave",
            "address_purpose": "LOCATION",
            "city": "Port St Lucie",
            "state": "FL",
            "postal_code": "349527521",
            "country_code": "US",
            "telephone_number": "772-398-3623",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEBAUCHE",
        "first_name": "SPENCER",
        "middle_name": "TERENCE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-03-18",
        "last_updated": "2024-11-14",
        "certification_date": "2024-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "NM",
            "license": "DO2022-0036",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmington, NM

Sources for this page

Verify at the official NPI Registry.