Mayedel a San Jose PC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

Legal business name

MAYEDEL A SAN JOSE PC

Doing business as

San Jose Wellness Center

Practice address

1245 Country Club Rd Ste 200
Santa Teresa, NM 88008-9743

Phone

(575) 332-4633

Fax

(877) 209-8941

NPI assigned

May 16, 2023

Organization subpart

No

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

Authorized official

Name

Dr. Mayedel San Jose, DNP, APRN, FNP-CNPI 1588018832

Title

Owner

Phone

(575) 332-4633

Specialties & licenses 2

Addresses

Other names 1

• San Jose Wellness Center Doing business as

Medicare fee-for-service enrollment

Enrolled in NM

Enrollment records 1

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

CLIA laboratory certificates

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mayedel San Jose, DNP, APRN, FNP-C

  • Family Nurse Practitioner
  • Santa Teresa, NM
  • NPI 1588018832
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1684195200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1758758400000",
    "number": "1083305510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1245 COUNTRY CLUB RD STE 200",
            "city": "SANTA TERESA",
            "state": "NM",
            "postal_code": "880089743",
            "telephone_number": "575-332-4633",
            "fax_number": "877-209-8941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1245 COUNTRY CLUB RD STE 200",
            "city": "SANTA TERESA",
            "state": "NM",
            "postal_code": "880089743",
            "telephone_number": "575-332-4633",
            "fax_number": "877-209-8941"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAYEDEL A SAN JOSE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-16",
        "last_updated": "2025-09-25",
        "certification_date": "2025-09-25",
        "status": "A",
        "authorized_official_last_name": "SAN JOSE",
        "authorized_official_first_name": "MAYEDEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "575-332-4633",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DNP, APRN, FNP-C"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "San Jose Wellness Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "San Jose Wellness Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sujey Yanet Martinez
• Yvonne Alejandra Martinez, APRN, FNP-BC
• Laura G. Marusich, MPT
• Taizen D Mata Chavira
• Carol L Maupin-Macias, OTR
• Elizabeth Mays
• Amanda McCormick
• Riley McFarland
• Christina Melendez
• Carla Mendez

• Family Nurse Practitioner in Santa Teresa, NM
• Providers in Santa Teresa, NM by specialty
• Family Nurse Practitioner in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2025; 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.