Individual provider Active NPI

Stephen H. Haynes, MD

  • General Practice Physician
  • Clovis, NM
National Provider Identifier
1790735587
Registry record updated Oct 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
82-61 Issued in NM
Practice address
1833 W 21St St
Clovis, NM 88101-4023
Phone
(575) 763-5585
Fax
(575) 763-6051
NPI assigned
May 11, 2006
Last updated
Oct 17, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 82-61 NM Primary

Addresses

Primary practice location

1833 W 21St St
Clovis, NM 88101-4023

Mailing address

1833 W 21St St
Clovis, NM 88101-4023
Phone (575) 763-5585

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061128000096 NM Practitioner - General SurgeryPractitioner - General Practice 4880503671 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General SurgeryAlso: General Practice
Education
University of New Mexico School of Medicine, 1977
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1937 W 21St St
Clovis, NM 88101-4025

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
18.43 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
61.45

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
82-61NMMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Associated Physicians & Practitioners LLC General Practice CurrentSince Feb 16, 2009 Accepting new patients
Eastern New Mexico Physicians and Surgeons LLC PastSince Aug 20, 2007 Accepting new patients
James R Sawyer MD PC Past Accepting new patients

Locations

1833 W 21st St
Clovis, NM 88101
Phone (575) 763-5585

1937 W 21st St
Clovis, NM 88101
Phone (505) 742-2500

Organizations & group practices 3

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.

Hospital & facility affiliations 3

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": "1147305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729123200000",
    "number": "1790735587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1833 W 21ST ST",
            "city": "CLOVIS",
            "state": "NM",
            "postal_code": "881014023",
            "telephone_number": "575-763-5585",
            "fax_number": "575-763-6051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1833 W 21ST ST",
            "city": "CLOVIS",
            "state": "NM",
            "postal_code": "881014023",
            "telephone_number": "575-763-5585",
            "fax_number": "575-763-6051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAYNES",
        "first_name": "STEPHEN",
        "middle_name": "H.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-11",
        "last_updated": "2024-10-17",
        "certification_date": "2024-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NM",
            "license": "82-61",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clovis, NM

Sources for this page

Verify at the official NPI Registry.