NPIMap

Organization Active NPI

St Vincent Hospital

Doing business as CHRISTUS St. Vincent Pediatrics

  • Pediatrics Physician
  • Santa Fe, NM
National Provider Identifier
1063367803
Registry record updated Feb 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
ST VINCENT HOSPITAL
Doing business as
CHRISTUS St. Vincent Pediatrics
Practice address
1620 Hospital Dr
Santa Fe, NM 87505-4754
Phone
(505) 913-4901
Fax
(505) 913-6426
NPI assigned
Feb 26, 2026
Last updated
Feb 26, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Carla L Gomez
Title
Payer Enrollment Coordinator
Phone
(505) 913-5227

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X Primary

Addresses

Primary practice location

1620 Hospital Dr
Santa Fe, NM 87505-4754

Mailing address

1620 Hospital Dr
Santa Fe, NM 87505-4754
Phone (505) 913-4901

Other names 1

  • CHRISTUS St. Vincent Pediatrics Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040105000372 NM Part B Supplier - Clinic/Group Practice 6608775135 Receives reassigned benefits from 425 practitioners
Practice locations: Santa Fe, NM; Los Alamos, NM; Albuquerque, NM; Espanola, NM; Farmington, NM; Las Vegas, NM

Other NPIs with the same Medicare PAC ID 8

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
32D2337380Christus St Vincent Pediatrics1620 Hospital Drive, Santa Fe, NM 87505Certificate of waiverJan 21, 2028

National Provider Directory

National Provider Directory
Tax ID family
Santa Fe Med Lab28 organizations share this tax ID, including this one

Other organizations with this tax ID 27

Organizations that report the same tax identification number in the National Provider Directory.

View all 27

Practitioners & affiliated clinicians

Practitioners 425

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 425

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1772064000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1772064000000",
    "number": "1063367803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1620 HOSPITAL DR",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875054754",
            "telephone_number": "505-913-4901",
            "fax_number": "505-913-6426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1620 HOSPITAL DR",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875054754",
            "telephone_number": "505-913-4901",
            "fax_number": "505-913-6426"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST VINCENT HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-02-26",
        "last_updated": "2026-02-26",
        "certification_date": "2026-02-26",
        "status": "A",
        "authorized_official_last_name": "GOMEZ",
        "authorized_official_first_name": "CARLA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PAYER ENROLLMENT COORDINATOR",
        "authorized_official_telephone_number": "505-913-5227"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CHRISTUS St. Vincent Pediatrics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Santa Fe, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.