Santa Teresa Family Medical Center

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

CNP-017111 Issued in NM

Legal business name

SANTA TERESA FAMILY MEDICAL CENTER

Practice address

5055 McNutt Rd
Santa Teresa, NM 88008-9442

Phone

(575) 589-5005

NPI assigned

May 23, 2017

Last updated

Jul 21, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mario Vela, DNP,FNP-CNPI 1023068012

Title

Owner

Phone

(575) 589-5005

Specialties & licenses 1

Addresses

Other identifiers 1

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 4

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.

• Mario Vela, FNP, DNP

  • Family Nurse Practitioner
  • Santa Teresa, NM
  • NPI 1023068012
  Medicare reassignment Care Compare group NPD Authorized official
• Tamra Renae Varela, FNP-C

  • Nurse Practitioner
  • Santa Teresa, NM
  • NPI 1679053722
  Medicare reassignment Care Compare group NPD
• Marc Houde, FNP-C

  • Family Nurse Practitioner
  • El Paso, TX
  • NPI 1104455666

  NM

  Medicare reassignment Care Compare group NPD
• Alfred Basil Varela, M.D,

  • Specialist
  • Santa Teresa, NM
  • NPI 1699766816
  Medicare reassignment NPD

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

{
    "created_epoch": "1495497600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1144757063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5055 MCNUTT RD",
            "city": "SANTA TERESA",
            "state": "NM",
            "postal_code": "880089442",
            "telephone_number": "575-589-5005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5055 MCNUTT RD",
            "city": "SANTA TERESA",
            "state": "NM",
            "postal_code": "880089442",
            "telephone_number": "575-589-5005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SANTA TERESA FAMILY MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-23",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "VELA",
        "authorized_official_first_name": "MARIO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "575-589-5005",
        "authorized_official_credential": "DNP,FNP-C"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NM",
            "license": "CNP-017111",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "82-1390204",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Samantha Sanchez
• Sandra L Shuya PC
• Peter K. Sangra, MD
• Santa Teresa Chiropractic Center
• Santa Teresa Cosmetic and Family Dentistry LLC (Santa Teresa Smiles)
• Santa Teresa Medical Care Center PC
• Santa Teresa Occmed Center, PC
• Joaquin F Santillan, MPT
• Sandra Michelle Santos Rodriguez, LPCC
• Manuel A Saucedo Cano

• Clinic/Center in Santa Teresa, NM
• Providers in Santa Teresa, NM by specialty
• Clinic/Center in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.