St. Vincent Hospital
Organization Active NPI Psychiatric Hospital Unit · Santa Fe, NM
NPI 1154477941 · NPPES record last updated Jan 6, 2011
Key facts
- NPI
- 1154477941
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Psychiatric Hospital Unit 273R00000X
- License
- 6296 (NM)
- Legal business name
- ST. VINCENT HOSPITAL
- Practice address
- 455 Saint Michaels Dr
Santa Fe, NM 87505-7601 - Phone
- (505) 913-5470
- Fax
- (505) 913-6489
- NPI assigned
- Jan 26, 2007
- Organization subpart
- No
Authorized official
- Name
- Joseph Alex Valdez
- Title
- Ceo
- Phone
- (505) 820-5202
Other NPIs on the same Medicare enrollment 1
Other NPIs with the same Medicare PAC ID 8
Related certifications (CCN) 1
Facilities with the same owner 47
Practitioners 336
-
Yaw Amaning Adjei-Poku, M.D.
-
Nataliya Afanasyeva, CNP
-
Robert Amjad Ali, MD
-
Eric William Anderson, M.D.
-
Brant Allen Bair, MD
-
Rebecca B Bair, MD
-
Avelina Bardwell, MD
-
Neil Pitero Barranta, CRNA
-
Carolyn A. Bauer, PA-C
-
Colin Berry, MD
-
Elisabeth M Bishop, M.D.
-
James Andrew Botros, M.D.
-
Emily Bowling, AA
-
David Bracho, D.O.
-
Mariann Bregin, NP
-
John E. Broom, M.D.
-
Nathaniel Joseph Brown, MD, PHD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in NM
Hospital certification: CCN 32S002
- Legal name
- ST VINCENT HOSPITAL
- Doing business as
- CHRISTUS ST VINCENT REGIONAL MEDICAL CENTER
- Organization structure
- Corporation · Non-profit
- Incorporated
- Mar 3, 1967 in NM
- Enrollment address
- 455 Saint Michaels Dr
Santa Fe, NM 87505-7601 - Hospital subgroups
- Psychiatric unit
All disclosed owners & managing parties 15
| Name | Role | Since | Share |
|---|---|---|---|
| Jeffrey Puckett |
Corporate Director |
Feb 8, 2024 | |
| Vernon O Hamilton |
Corporate Director |
Jan 1, 2022 | |
| Christus Health |
5% Or Greater Direct Ownership Interest | Apr 9, 2008 | |
| Hope Wade |
Corporate Officer | Apr 24, 2017 | |
| Sayuri Yamada |
Corporate Director |
Jul 16, 2020 | |
| Sam R Bagchi |
Corporate Director |
Feb 8, 2024 | |
| Mark Stanley Puczynski |
Corporate Director | Jan 1, 2019 | |
| Kimberly King Webb |
Corporate Director |
Feb 8, 2024 | |
| Todd Mason |
Corporate Officer |
Sep 19, 2025 | |
| Jerry Jones |
Corporate Director |
Nov 18, 2021 | |
| Lillian Montoya |
Corporate Officer | Jun 15, 2018 | |
| Corporate Director | Jun 15, 2018 | ||
| W-2 Managing Employee | Jun 15, 2018 | ||
| J Lindsey Bradley |
Corporate Director | Aug 1, 2017 | |
| Audrey Webber |
Corporate Director |
Jul 18, 2024 | |
| Daya Khalsa |
Corporate Director | Jan 1, 2019 | |
| Jaclynn Jodessa Harrison |
Corporate Director |
May 1, 2025 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040105000372 | NM | Part B Supplier - Clinic/Group Practice | 6608775135 |
Receives reassigned benefits from 425 practitioners This NPI is an additional NPI on the enrollment Practice locations: Santa Fe, NM; Los Alamos, NM; Albuquerque, NM; Espanola, NM; Farmington, NM; Las Vegas, NM |
| O20071217000794 | NM | Part a Provider - Hospital | 6608775135 |
1 other NPI on this enrollment Practice locations: Santa Fe, NM |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric Hospital Unit | 273R00000X | 6296 | NM | Yes |
Addresses
Primary practice location
455 Saint Michaels Dr
Santa Fe, NM 87505-7601
Mailing address
PO Box C12000
Santa Fe, NM 87504-7000
Phone (505) 913-3155
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00612 | Medicaid | NM |
Other names
- CHRISTUS St. Vincent Regional Medical Center
Other providers in Santa Fe, NM
- St Vincent Hospital
- St Vincent Hospital
- Anabella St. Peter
- St. Vincent Hospital
- St. Vincent Hospital
- St. Vincent Hospital
- St. Vincent Hospital
- St. Vincent Hospital
- St. Vincent Hospital
- St. Vincent Hospital
All providers in Santa Fe, NM · Psychiatric Hospital Unit in New Mexico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 6, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.