Individual provider Active NPI

Scott Ryan Jeansonne, D.O.

  • Family Medicine Physician
  • Los Lunas, NM
National Provider Identifier
1902034879
Registry record updated May 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A-1580-10 Issued in NM
Practice address
145 Don Pasqual Rd NW
Los Lunas, NM 87031-8841
Phone
(505) 873-7400
NPI assigned
Jun 30, 2009
Last updated
May 14, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 14, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A-1580-10 NM Primary

Addresses

Primary practice location

145 Don Pasqual Rd NW
Los Lunas, NM 87031-8841

Mailing address

PO Box 912678
Denver, CO 80291-2678
Phone (505) 241-5182

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
I20121026000046 NM Practitioner - Family Practice 9739339821 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2001 Centro Familiar Blvd SW
Albuquerque, NM 87105-4592
Phone (505) 873-7400

8 Medical Ctr Rd
Edgewood, NM 87015-7086
Phone (505) 281-3406

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
First Choice Community Healthcare, Inc. Family Medicine CurrentSince Sep 28, 2012 Accepting new patients
First Choice Community Healthcare, Inc. Family Medicine CurrentSince Sep 28, 2012 Accepting new patients

Locations

2001 El Centro Familiar Blvd SW
Albuquerque, NM 87105
Phone (505) 873-7462

120 S 9th St
Belen, NM 87002
Phone (505) 861-1013

145 Don Pasqual Rd NW
Los Lunas, NM 87031
Phone (505) 224-8740

Organizations & group practices 2

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 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": "1246320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747180800000",
    "number": "1902034879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 912678",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802912678",
            "telephone_number": "505-241-5182"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "145 DON PASQUAL RD NW",
            "city": "LOS LUNAS",
            "state": "NM",
            "postal_code": "870318841",
            "telephone_number": "505-873-7400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEANSONNE",
        "first_name": "SCOTT",
        "middle_name": "RYAN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-06-30",
        "last_updated": "2025-05-14",
        "certification_date": "2025-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NM",
            "license": "A-1580-10",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Lunas, NM

Sources for this page

Verify at the official NPI Registry.