Individual provider Active NPI

Lauren Elise Pincomb Apodaca

  • Physician Assistant
  • Las Cruces, NM
National Provider Identifier
1902405442
Registry record updated Feb 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA2022-0123 Issued in NM
Practice address
2325 1/2 Burke Rd
Las Cruces, NM 88007-5012
Phone
(575) 932-8167
NPI assigned
Oct 24, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA2022-0123 NM Primary

Addresses

Primary practice location

2325 1/2 Burke Rd
Las Cruces, NM 88007-5012

Mailing address

2325 1/2 Burke Rd
Las Cruces, NM 88007-5012
Phone (575) 932-8167

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221221000408 NM Practitioner - Physician Assistant 1557731262 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

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 and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1603497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676592000000",
    "number": "1902405442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2325 1/2 BURKE RD",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880075012",
            "telephone_number": "575-932-8167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2325 1/2 BURKE RD",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880075012",
            "telephone_number": "575-932-8167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PINCOMB APODACA",
        "first_name": "LAUREN",
        "middle_name": "ELISE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-24",
        "last_updated": "2023-02-17",
        "certification_date": "2023-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NM",
            "license": "PA2022-0123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Cruces, NM

Sources for this page

Verify at the official NPI Registry.