- in Portales, NM

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is a Family Medicine based in Portales, New Mexico. is licensed to practice in New Mexico (license number MD2011-0222) and their current practice location is 42121 Us Hwy 70, Portales, New Mexico. It can be reached at their office (for appointments etc.) via phone at (575) 356-6652.

NPI number for is 1093801292 and their current mailing address is Po Box 299, 42121 Us Hwy 70, Portales, New Mexico. does not participate in medicare program and thus does not accept medicare assignments. The facility's NPI Number is 1093801292.

Contact Information

42121 Us Hwy 70,
Portales, NM 88130-9357
(575) 356-6652
(505) 226-3636

Map and Direction




Healthcare Provider's Profile

Full Name
TypeFacility
SpecialityFamily Medicine
Location42121 Us Hwy 70, Portales, New Mexico
Accepts Medicare AssignmentsDoes not participate in Medicare Program. The facility may not accept medicare assignment.
  NPI Data:
  • NPI Number: 1093801292
  • Provider Enumeration Date: 10/05/2006
  • Last Update Date: 10/29/2012

Medical Identifiers

Medical identifiers for such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1093801292NPI-NPPES
1598750614OtherNPI
1215021696OtherNPI
1245292242OtherNPI
1780778159OtherNPI
1013046994OtherNPI
1013221969OtherNMNPI
1841242831OtherNPI
1790926814OtherNPI
1255641338OtherNMNPI
1669646006OtherNPI
1528010279OtherNPI

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
133V00000XDietitian, Registered 072 (New Mexico)Secondary
207Q00000XFamily Medicine MD2011-0222 (New Mexico)Primary
207Q00000XFamily Medicine PA2004-0028 (New Mexico)Secondary
207Q00000XFamily Medicine MD2010-0626 (New Mexico)Secondary
207Q00000XFamily Medicine 87-277 (New Mexico)Secondary
207Q00000XFamily Medicine CNP-01941 (New Mexico)Secondary
207Q00000XFamily Medicine MD2010-0558 (New Mexico)Secondary
207Q00000XFamily Medicine A-1584-10 (New Mexico)Secondary
207Q00000XFamily Medicine CNP00289 (New Mexico)Secondary
208600000XSurgery MD2004-0707 (New Mexico)Secondary
208VP0000XPain Medicine - Pain Medicine MD2004-0760 (New Mexico)Secondary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. is NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address

Po Box 299, 42121 Us Hwy 70,
Portales, NM 88130-0299

Ph: (575) 356-6652
42121 Us Hwy 70,
Portales, NM 88130-9357

Ph: (575) 356-6652

Reviews and Comments



Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.