Individual provider Active NPI

Herbert V Rachelson, MD

  • Orthopaedic Surgery Physician
  • Espanola, NM
National Provider Identifier
1104971886
Registry record updated Apr 6, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
76-249 Issued in NM
Practice address
Espanola Multi-Specialty Clinic
1010 Spruce St
Espanola, NM 87532
Phone
(505) 367-0340
Fax
(505) 367-0346
NPI assigned
Jan 24, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Hand Surgery Physician 207XS0106X 76-249 NM
Orthopaedic Surgery Physician 207X00000X 76-249 NM Primary

Addresses

Primary practice location

Espanola Multi-Specialty Clinic
1010 Spruce St
Espanola, NM 87532

Mailing address

PO Box 26666
PHS Provider Enrollment
Albuquerque, NM 87125-6666
Phone (505) 923-5356

Other identifiers 1

IdentifierTypeStateIssuer
22384MedicaidNM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071121000208 NM Practitioner - Orthopedic Surgery 1557393667 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
76-249NMMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Presbyterian Healthcare Services CurrentSince Nov 1, 2007 Accepting new patients
Family Practice Associates of Taos CurrentSince Jul 16, 2019 Accepting new patients
Presbyterian Healthcare Services CurrentSince Nov 1, 2007 Accepting new patients
Family Practice Associates of Taos CurrentSince Jul 16, 2019 Accepting new patients
Taos Health Systems, Inc., Holy Cross Hospital Past Accepting new patients

Locations

2200 W 21st St
Clovis, NM 88101
Phone (505) 769-7577

1010 Spruce St
Espanola, NM 87532
Phone (505) 367-0340

630 Paseo del Pueblo Sur
Ste 150
Taos, NM 87571
Phone (505) 758-3005

630 S Santa Fe Rd
Taos, NM 87571
Phone (505) 758-3005

Interoperability endpoints

  • Direct secure messaging: hrachelson15972@direct.phs.org
  • FHIR API: https://api.platform.athenahealth.com/2635/brand/1/csg/1/fhir/r4
  • Direct secure messaging: herbert.rachelson.1@2635.direct.athenahealth.com

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1169596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491436800000",
    "number": "1104971886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 26666",
            "address_2": "PHS PROVIDER ENROLLMENT",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871256666",
            "telephone_number": "505-923-5356",
            "fax_number": "505-923-5354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "ESPANOLA MULTI-SPECIALTY CLINIC",
            "address_2": "1010 SPRUCE ST",
            "city": "ESPANOLA",
            "state": "NM",
            "postal_code": "87532",
            "telephone_number": "505-367-0340",
            "fax_number": "505-367-0346"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RACHELSON",
        "first_name": "HERBERT",
        "middle_name": "V",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-24",
        "last_updated": "2017-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XS0106X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Hand Surgery",
            "state": "NM",
            "license": "76-249",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NM",
            "license": "76-249",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "22384",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Espanola, NM

Sources for this page

Verify at the official NPI Registry.