Stephen H. Haynes, MD
Individual provider Active NPI General Practice Physician · Clovis, NM
NPI 1790735587 · NPPES record last updated Oct 17, 2024
Key facts
- NPI
- 1790735587
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Physician 208D00000X
- License
- 82-61 (NM)
- Practice address
- 1833 W 21St St
Clovis, NM 88101-4023 - Phone
- (575) 763-5585
- Fax
- (575) 763-6051
- NPI assigned
- May 11, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 3
Hospital & facility affiliations 3
Medicare Care Compare profile
- Specialty
- General Surgery
- 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
- Excelacare Home Health
- Plains Regional Medical Center
- Roosevelt General Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 18.43 of 100
- Quality
- 0
- Improvement activities
- 0
- Cost
- 61.45
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in 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 |
|---|---|---|---|---|
| I20061128000096 | NM | Practitioner - General Surgery |
4880503671 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 82-61 | NM | MD | General Practice Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Associated Physicians & Practitioners LLC | General Practice | Current |
Accepting new patients |
| Eastern New Mexico Physicians and Surgeons LLC | Past |
Accepting new patients | |
| James R Sawyer MD PC | Past | Accepting new patients |
Locations
1937 W 21st St
Clovis, NM 88101
Phone (505) 742-2500
1833 W 21st St
Clovis, NM 88101
Phone (575) 763-5585
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | 82-61 | NM | Yes |
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
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 19018 | Medicaid | NM | |
| P00347709 | Other | NM | RAILROAD MEDICARE PIN |
Other providers in Clovis, NM
- Kelly Michael Hartz
- Mohammad R Hassan
- Chesney Chellise Hatch
- Christal J Hatley
- Britney D'Von Hawkins
- Tabitha Star Haynie
- Hazen Chiropractic Center
- Shenye He
- Wayne Keith Head
- Healthy Haven Counseling & Consulting Services, LLC
All providers in Clovis, NM · General Practice 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 Oct 17, 2024. 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.