Individual provider Active NPI

Wesley Mildenhall, CRNA

  • Certified Registered Nurse Anesthetist
  • Las Cruces, NM
National Provider Identifier
1871984013
Registry record updated Feb 10, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
CRNA-01353 Issued in NM
Practice address
2450 S Telshor Blvd
Las Cruces, NM 88011-5069
Phone
(575) 522-8641
NPI assigned
Feb 10, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X CRNA-01353 NM Primary

Addresses

Primary practice location

2450 S Telshor Blvd
Las Cruces, NM 88011-5069

Mailing address

10 Commerce Dr
New Rochelle, NY 10801-5253

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM, TX2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20150310001090 NM Practitioner - Certified Registered Nurse Anesthetist (Crna) 3870819824 Reassigns benefits to 2 organizations
I20151003000001 TX Practitioner - Certified Registered Nurse Anesthetist (Crna) 3870819824 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Main Street Anesthesia of New Mexico, LLCGroup PAC ID 3476807538, 228 clinicians

Practice addresses (Care Compare)

4311 E Lohman Ave
Mountain View Regional Medical Cent
Las Cruces, NM 88011-8255
Phone (575) 556-7600

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
74.5 of 100Reported as group
Quality
70
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
CRNA-01353NMMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesia Associates of El Paso PA CurrentSince Dec 14, 2015 Accepting new patients
Texas Tech University Health Sciences Center El Paso CurrentSince Sep 1, 2015 Accepting new patients
Main Street Anesthesia of New Mexico, LLC CurrentSince Apr 20, 2021 Accepting new patients
Texas Tech University Health Sciences Center El Paso CurrentSince Sep 1, 2015 Accepting new patients
Resource Anesthesiology Associates of NM Inc CurrentSince Feb 9, 2015 Accepting new patients
Texas Tech University Health Sciences Center El Paso Current Accepting new patients
Texas Tech University Health Sciences Center Odessa Past Accepting new patients

Locations

4311 E Lohman Ave
Las Cruces, NM 88011
Phone (505) 556-6800

4351 E Lohman Ave
Ste 102
Las Cruces, NM 88011
Phone (575) 532-3300

2450 S Telshor Blvd
Las Cruces, NM 88011
Phone (505) 522-8641

117 E 19th St
Roswell, NM 88201
Phone (505) 727-2000

4845 Alameda Ave
El Paso, TX 79905
Phone (915) 215-5700

4815 Alameda Ave
El Paso, TX 79905
Phone (915) 215-6000

4800 Alberta Ave
#101
El Paso, TX 79905
Phone (915) 215-4478

4800 Alberta Ave
El Paso, TX 79905
Phone (915) 215-5666

4615 Alameda Ave
El Paso, TX 79905
Phone (432) 268-7247

Interoperability endpoints

  • Direct secure messaging: wesley.mildenhall@direct.myhealthep.org

Organizations & group practices 7

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 1

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": "1423526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1423526400000",
    "number": "1871984013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 COMMERCE DR",
            "city": "NEW ROCHELLE",
            "state": "NY",
            "postal_code": "108015253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2450 S TELSHOR BLVD",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880115069",
            "telephone_number": "575-522-8641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILDENHALL",
        "first_name": "WESLEY",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-02-10",
        "last_updated": "2015-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NM",
            "license": "CRNA-01353",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Cruces, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.