Jon Roger Hall, MD
Individual provider Active NPI Ophthalmology Physician · Las Cruces, NM
NPI 1972506368 · NPPES record last updated Apr 24, 2008
Key facts
- NPI
- 1972506368
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Ophthalmology Physician 207W00000X
- License
- 2001-205 (NM)
- Practice address
- 755 S Telshor Blvd
Ste 101C
Las Cruces, NM 88011-4644 - Phone
- (575) 522-3393
- NPI assigned
- May 31, 2005
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 3
Medicare Care Compare profile
- Specialty
- Ophthalmology
- Education
- University of Texas Medical Branch at Galveston, 1968
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Fillmore Eye Clinic Incorporated
Practice addresses (Care Compare)
4111 Camino Coyote
A
Las Cruces, NM 88011-7096
Phone (575) 522-3393
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 |
|---|---|---|---|---|
| I20110208000361 | NM | Practitioner - Ophthalmology | 5991773780 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2001-205 | NM | MD | Ophthalmology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fillmore Eye Clinic Incorporated | Ophthalmology | Current |
Accepting new patients |
| Fillmore Eye Clinic Incorporated | Ophthalmology | Current |
Accepting new patients |
| Fillmore Eye Clinic Incorporated | Past | Accepting new patients |
Locations
1124 10th St
Alamogordo, NM 88310
Phone (575) 434-1200
1120 10th St
Alamogordo, NM 88310
Phone (505) 437-6838
805 W Bush Ave
Artesia, NM 88210
850 W Florida St
Deming, NM 88030
Phone (505) 546-6548
755 S Telshor Blvd
Ste 101C
Las Cruces, NM 88011
Phone (575) 522-3393
4111 Camino Coyote
Las Cruces, NM 88011
Phone (575) 562-6767
4111 Camino Coyote
#A
Las Cruces, NM 88011
Phone (575) 522-3393
1415 S Valley Dr
Ste 200
Las Cruces, NM 88005
Phone (575) 800-5931
700 Mechem Dr
Ruidoso, NM 88345
Phone (575) 257-9300
1210 E 32nd St
Silver City, NM 88061
Phone (505) 538-3721
205 E Smith Ave
Truth Or Consequences, NM 87901
Phone (575) 522-3393
Interoperability endpoints
- jhall@fec.intellechartdirect.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | 2001-205 | NM | Yes |
Addresses
Primary practice location
755 S Telshor Blvd
Ste 101C
Las Cruces, NM 88011-4644
Mailing address
755 S Telshor Blvd
Ste 101C
Las Cruces, NM 88011-4644
Phone (575) 522-3393
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 32605 | Other | CIGNA/LOVELACE | |
| NM009780 | Other | NM | BLUE CROSS/BLUE SHEILD |
Other providers in Las Cruces, NM
- Kathleen Sue Hales
- Ashley Hall
- Bridgen Hall
- Diana Karen Hall
- Elisa R Hall
- Rhonda Hall
- Gabriela Hallowell
- Kaitlyn Mae Hallwyler
- Kyla Halsor
- Maria Angelina Halsted
All providers in Las Cruces, NM · Ophthalmology 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 Apr 24, 2008. 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.