Active NPI
John J Tucker II, D.O.
- Family Medicine Physician
- Las Cruces, NM
National Provider Identifier
1972765592
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- A-1633-11
- Practice address
- 299 Montana Ave
Las Cruces, NM 88005-3223 - Phone
- (575) 525-5703
- Fax
- (575) 525-5774
- NPI assigned
- Jun 25, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | SL0564 | NV | |
| Family Medicine Physician | 207Q00000X | A-1633-11 | NM | Primary |
Addresses
Primary practice location
299 Montana Ave
Las Cruces, NM 88005-3223
Mailing address
299 Montana Ave
Las Cruces, NM 88005-3223
Phone (575) 523-4700
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 22909311 | Medicaid | NM |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250221001139 | NM | Order and Referring Only - Hospice/Palliative Care | 2365615929 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SL0564 | NV | MD | Student in an Organized Health Care Education/Training Program |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1214352000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1759104000000",
"number": "1972765592",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "299 MONTANA AVE",
"city": "LAS CRUCES",
"state": "NM",
"postal_code": "880053223",
"telephone_number": "575-523-4700",
"fax_number": "575-525-5774"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "299 MONTANA AVE",
"city": "LAS CRUCES",
"state": "NM",
"postal_code": "880053223",
"telephone_number": "575-525-5703",
"fax_number": "575-525-5774"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TUCKER",
"first_name": "JOHN",
"middle_name": "J",
"name_suffix": "II",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-06-25",
"last_updated": "2025-09-29",
"certification_date": "2025-09-29",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "NV",
"license": "SL0564",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "NM",
"license": "A-1633-11",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "22909311",
"state": "NM"
}
],
"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 Sep 29, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.