JENNIFER AGOSTA (NPI# 1174749014) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174749014 |
| Entity Type | Individual |
| Full Name | JENNIFER AGOSTA |
| Credential | MD |
| Practice Address |
4351 E Lohman Ave Ste 320 Las Cruces NM 88011-8262 |
| Practice Telephone | 5755563240 |
| Practice Fax Number | 5755223092 |
| Mailing Telephone | 5755563240 |
| Mailing Fax Number | 5755223092 |
| Enumeration Date | 2007-04-18 |
| Last Update Date | 2017-12-21 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | MD2008-0157 | NM | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NM | 29380049 | 05 | |
| NM | MEDICARE ID | 570315YY54 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 4351 E Lohman Ave, Suite 409, Las Cruces, NM 880118259 | 5755563240 | 5755223092 |
| Street Address |
4351 E LOHMAN AVE STE 320 |
| City | LAS CRUCES |
| State | NM |
| Zip Code | 88011-8262 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033521257 | Omar Hashmi | Surgery | 4351 E Lohman Ave Ste 320, Las Cruces, NM 88011 | 2014-05-22 |
| 1164738399 | Kerry Shawn Harris | Nurse Practitioner | 4351 E Lohman Ave Ste 320, Las Cruces, NM 88011-8262 | 2010-08-25 |
| 1497983274 | Renata Brodsky | Surgery | 4351 E Lohman Ave Ste 320, Las Cruces, NM 88011-8262 | 2009-06-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356954648 | Asc of The Heart Institute | Internal Medicine | 1250 N Sonoma Ranch Blvd, Las Cruces, NM 88011 | 2020-08-26 |
| 1104449206 | Kruti Gitesh Shah | Student in an Organized Health Care Education/Training Program | Mountain View Regional Medical Cente, Graduate Medical Education, 4351 E Lohman Ave Suite 300, Las Cruces, NM 88011 | 2020-05-22 |
| 1831719368 | Borna Mansouri | Student in an Organized Health Care Education/Training Program | 4351 E. Lahman Ave, Suite 300, Moutnainview Regional Medical Center Graduta, Las Cruces, NM 88011 | 2020-04-24 |
| 1306474408 | Madonna Petula Phillip | Student in an Organized Health Care Education/Training Program | 4351 E Lohmon Avenue Suite 300, Las Cruces, NM 88011 | 2020-04-01 |
| 1285267849 | Back In Action Therapy of Las Cruces | Occupational Therapist | 4440 Sonoma Ranch Blvd, Suite F, Las Cruces, NM 88011 | 2020-02-21 |
| 1649818725 | Kimberly Ann Smetzer | Registered Nurse | 4401 East Lohman, Building 5, Las Cruces, NM 88011 | 2019-12-19 |
| 1548806375 | Melinda Michelle Fowler | Social Worker | 2605 Terrace Drive, Las Cruces, NM 88011 | 2019-11-27 |
| 1871134692 | Rio Grande Hematology and Oncology, LLC | Internal Medicine | 4391 East Lohman Ave., Las Cruces, NM 88011 | 2019-10-02 |
| 1972083640 | Lorianna R. Narvaez | Counselor | 1155 S. Telshor Suite 302-a, Las Cruces, NM 88011 | 2018-08-21 |
| 1215416524 | Aday Orthodontics, PC | Dentist | 2701 Missouri Ave., Suite D, Las Cruces, NM 88011 | 2018-08-08 |
| Find all providers in zip 88011 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184008153 | Syed Rafique Ahmed | Internal Medicine | 3030 W Picacho Ave Ste D, Las Cruces, NM 88007-4721 | 2015-07-19 |
| 1770966699 | Edna Maritza Juarez | Internal Medicine | 2450 S. Telshor Blvd., Bldg. D., Suite 1, Las Cruces, NM 88011 | 2015-07-09 |
| 1124406269 | Internal Medicine Premium Health Care PC | Internal Medicine | 525 E Lohman Ave, Ste D, Las Cruces, NM 88001-3394 | 2015-05-08 |
| 1669866174 | Bat Ray Inpatient Services LLC | Internal Medicine | 2560 Samaritan Dr, Las Cruces, NM 88001-1170 | 2015-03-23 |
| 1356758213 | Ditashree Devkota | Internal Medicine | 4311 E Lohman Ave # 4, Las Cruces, NM 88011 | 2014-07-11 |
| 1225382427 | Judi Rae Voelz | Internal Medicine | Msc 3529, New Mexico State University, Las Cruces, NM 88003-8001 | 2012-11-09 |
| 1568718526 | Cristina Amelia Perez Gomez | Internal Medicine | 3901 Sonoma Springs Ave Apt 202, Las Cruces, NM 88011-7107 | 2012-07-27 |
| 1437413820 | Chinenye Anthonia Osuorji | Internal Medicine | 3085 Eclipse Ridge Ln, Las Cruces, NM 88011-1667 | 2012-06-29 |
| 1528356037 | Parikshit Padhi | Internal Medicine | 2530 S Telshor Blvd Suite 107, Las Cruces, NM 88011-4756 | 2011-07-18 |
| 1659679157 | Wellmed Medical Group, P.a. | Internal Medicine | 530 N Telshor Blvd Ste C, Las Cruces, NM 88011-8243 | 2011-03-08 |
| Find all providers in LAS CRUCES | ||||
| City | LAS CRUCES |
| Zip Code | 88011 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.