Chenthuran Deivaraju
SAN MIGUEL CLINIC CORP


Address: 104 Legion Dr, Suite 4, Las Vegas, NM 87701-4804
Phone: 5054263613

Chenthuran Deivaraju (NPI# 1477832517, PAC ID# 3274853098) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is ORTHOPEDIC SURGERY.

Physician Overview

Nation Provider ID (NPI) 1477832517
PAC ID by PECOS 3274853098
Professional Enrollment ID I20150519001745
Full Name Chenthuran Deivaraju
Organization Legal Name SAN MIGUEL CLINIC CORP
Address 104 Legion Dr
Suite 4
Las Vegas
NM 87701-4804
Phone Number 5054263613
Gender M
Graduation Year 2003
Primary Specialty ORTHOPEDIC SURGERY
Group Practice PAC ID 1254226079
Number of Group Practice Members 8
Accepts Medicare Assignment Y

Claims Based Hospital Affiliation

Claim Control Number (CCN) Legal Business Name
320085 MOUNTAIN VIEW REGIONAL MEDICAL CENTER
320003 ALTA VISTA REGIONAL HOSPITAL
321300 SIERRA VISTA HOSPITAL

Other Locations

Address Phone Organization
1135 S Main St, Las Cruces, NM 88005-2946 LAS CRUCES PHYSICIAN SERVICES LLC
4301 E Lohman Ave, Las Cruces, NM 88011-8255 LAS CRUCES PHYSICIAN SERVICES LLC
4311 E Lohman Ave, Las Cruces, NM 88011-8255 LAS CRUCES PHYSICIAN SERVICES LLC
4311 E Lohman Ave Fl, 1 Mountain View Anesthesia, Las Cruces, NM 88011-8255 5755567615 LAS CRUCES PHYSICIAN SERVICES LLC
4351 E Lohman Ave, Las Cruces, NM 88011-8260 LAS CRUCES PHYSICIAN SERVICES LLC
4371 E Lohman Ave, Las Cruces, NM 88011-8255 5755227798 LAS CRUCES PHYSICIAN SERVICES LLC
104 Legion Dr, Suite 4, Las Vegas, NM 87701-4804 5054263613 SAN MIGUEL CLINIC CORP
108 Legion Dr, Las Vegas, NM 87701-4898 SAN MIGUEL CLINIC CORP
2515 Ridge Runner Rd, Las Vegas, NM 87701-4972 5054252662 SAN MIGUEL CLINIC CORP
800 E 9th Ave, Truth Or Consequences, NM 87901-1954 5755329755 LAS CRUCES PHYSICIAN SERVICES LLC
800 E 9th Ave, Fl 2, Truth Or Consequences, NM 87901-1954 5755224767 LAS CRUCES PHYSICIAN SERVICES LLC

Individual EP (Eligible Professionals) Public Reporting – Performance Scores
Physician Quality Reporting System (PQRS) and non-PQRS Qualified Clinical Data Registry (QCDR)

Measure Identifier Measure Title Performance Rate Reporting Mechanism
ACI_EC_TRANS_PPHI_1 Security Risk Analysis %

Organization Information

Organization Legal Name SAN MIGUEL CLINIC CORP
Physicians 8

Physicians with the same organization

Name Specialty Organization Address
Nancy J Wright Pediatric Medicine San Miguel Clinic Corp 501 7th St, Las Vegas, NM 87701-3993
Wietske Moore Nurse Practitioner San Miguel Clinic Corp 2515 Ridge Runner Rd, Las Vegas, NM 87701-4972
Raymond F Ortiz Internal Medicine San Miguel Clinic Corp 2515 Ridge Runner Rd, Las Vegas, NM 87701-4972
Franklin Miller Pulmonary Disease San Miguel Clinic Corp 2515 Ridge Runner Rd, Las Vegas, NM 87701-4972
Tracy Wilkerson Obstetrics/gynecology San Miguel Clinic Corp 108 Legion Dr, Suite A, Las Vegas, NM 87701-4898
Morgan E Schopen Certified Nurse Midwife San Miguel Clinic Corp 108 Legion Dr, Suite A, Las Vegas, NM 87701-4898
Carol A Kiesling Obstetrics/gynecology San Miguel Clinic Corp 108 Legion Dr, Suite A, Las Vegas, NM 87701-4898

Office Location

Street Address 104 LEGION DR
SUITE 4
City LAS VEGAS
State NM
Zip 87701-4804

Physicians in the same location

Name Specialty Organization Address
Gary A Lamotte Diagnostic Radiology Rural Radiology Associates Pllc 104 Legion Dr, Las Vegas, NM 87701-4804
Joseph Andrew Orzel Diagnostic Radiology Rural Radiology Associates Pllc 104 Legion Dr, Las Vegas, NM 87701-4804
Rashonda Nichole Hall Nurse Practitioner App of New Mexico Hm Pllc 104 Legion Dr, Las Vegas, NM 87701-4804
Samuel L Moses Diagnostic Radiology Rural Radiology Associates Pllc 104 Legion Dr, Las Vegas, NM 87701-4804
Lovick P Thomas Vi Diagnostic Radiology Rural Radiology Associates Pllc 104 Legion Dr, Las Vegas, NM 87701-4804
Robert E Gordon Diagnostic Radiology Rural Radiology Associates Pllc 104 Legion Dr, Las Vegas, NM 87701-4804

Physicians in the same zip code

Name Specialty Organization Address
Jasmin U Breitung Internal Medicine 2213 Hot Springs Blvd, Las Vegas, NM 87701-3449
Bruce A Andersen Podiatry 109 Railroad Ave, Las Vegas, NM 87701-3853
Nancy J Wright Pediatric Medicine San Miguel Clinic Corp 501 7th St, Las Vegas, NM 87701-3993
Leigh A Trivino Physician Assistant El Centro Family Health 901 Baca Ave, Las Vegas, NM 87701-4000
Michael L Mcfall Physical Therapy 2810 Hot Springs Blvd, Suite A, Las Vegas, NM 87701-4119
G. Michael Lopez Internal Medicine 105 Mills Ave, Suite 300, Las Vegas, NM 87701-4169
Louise M La Plante Clinical Social Worker 3001 Hot Springs Blvd, Suite C, Las Vegas, NM 87701-4175
Matthew D Probst Physician Assistant El Centro Family Health 1235 8th St, Las Vegas, NM 87701-4219
Michael J Lee Physician Assistant El Centro Family Health 1235 8th St, Las Vegas, NM 87701-4219
Laura Robinson Nurse Practitioner El Centro Family Health 1235 8th St, Las Vegas, NM 87701-4219
Find all physicians in zip 87701

Competitor

Search similar physicians

City LAS VEGAS
Zip Code 87701
Specialty ORTHOPEDIC SURGERY
City + Specialty LAS VEGAS + ORTHOPEDIC SURGERY

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS)
Jurisdiction Medicare

This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.

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