Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Samuel Basiaka Itie, FNP-C

Individual provider Family Nurse Practitioner · NPI 1952794687

Samuel Basiaka Itie, FNP-C is a Nurse Practitioner in Roswell, New Mexico. Qualified in 2014, 12 years ago. Works from 2 locations, accepts Medicare assignment and offers telehealth. Licensed in New Mexico and Texas.

Years since qualifying
12
Licensed in
NM, TX
In the registry since
2015
Specialties on file
3
What do these letters mean?
FNP-C — Family Nurse Practitioner, Certified
A family nurse practitioner certified by the AANP.

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Practice location Address checks out

712 W Hobbs St
Roswell, NM 88203-3646
Phone: (575) 623-5263
Fax: (575) 623-5286
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 300 W Country Club Rd Ste 210, Roswell, NM 88201-5240 — (575) 625-1292

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 69489 (NM)
Family Nurse Practitioner Taxonomy 363LF0000X · Licence AP127554 (TX)
Psychiatric/Mental Health Nurse Practitioner Taxonomy 363LP0808X · Licence 69489 (NM)

Record details

NPI number1952794687
Entity typeIndividual (Type 1)
GenderMale
Credentials FNP-C
Sole proprietorNo
NPI enumeratedMarch 5, 2015
Last updated in NPPESAugust 18, 2025
Certification dateAugust 18, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2014 (12 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations2 on file with Medicare

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