Individual provider Active NPI

Todd D. Hultman, CNP

  • Nurse Practitioner
  • Santa Fe, NM
National Provider Identifier
1184669806
Registry record updated Jan 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
65648 Issued in NM
Practice address
1400 Chama Ave
Santa Fe, NM 87505-3372
Phone
(505) 988-2211
Fax
(303) 945-7844
NPI assigned
Jun 17, 2006
Last updated
Jan 3, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 991803-NP CO
Acute Care Nurse Practitioner 363LA2100X 254580 MA
Nurse Practitioner 363L00000X 65648 NM Primary

Addresses

Primary practice location

1400 Chama Ave
Santa Fe, NM 87505-3372

Mailing address

PO Box 26666
Provider Enrollment
Albuquerque, NM 87125-6666
Phone (505) 923-6770

Other identifiers 2

IdentifierTypeStateIssuer
701211MedicaidMA
69633517MedicaidCO

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220104000279 NM Practitioner - Nurse Practitioner 7214998871 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
St Vincent HospitalGroup PAC ID 6608775135, 335 clinicians

Practice addresses (Care Compare)

490 B W Zia Rd
4 Christus St Vincent
Santa Fe, NM 87505-7009
Phone (505) 913-3820

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
97.13 of 100Reported as apm
Quality
94.26
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
88.68 of 100Reported as group
Quality
82.35
Promoting interoperability
100
Improvement activities
40
Cost
76.6

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
991803-NPCOMDNurse Practitioner
65648NMMDNurse Practitioner
254580MAMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Presbyterian Healthcare Services CurrentSince Jan 4, 2022 Accepting new patients
Presbyterian Healthcare Services CurrentSince Jan 4, 2022 Accepting new patients
St. Vincent Hospital CurrentSince Aug 26, 2024 Accepting new patients
St Vincent Hospital CurrentSince Aug 26, 2024 Accepting new patients
St Vincent Hospital Current Accepting new patients

Locations

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

1400 Chama Ave
Santa Fe, NM 87505
Phone (505) 988-2211

445 Saint Michaels Dr
Santa Fe, NM 87505
Phone (505) 913-8900

455 Saint Michaels Dr
Santa Fe, NM 87505
Phone (505) 913-3361

465 Saint Michaels Dr
Ste 200
Santa Fe, NM 87505
Phone (505) 995-4901

490B W Zia Rd
Ste 4
Santa Fe, NM 87505
Phone (505) 913-3820

Interoperability endpoints

  • Direct secure messaging: thultman368549@christushealth.direct-ci.net

Organizations & group practices 6

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

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1150502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641168000000",
    "number": "1184669806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 26666",
            "address_2": "PROVIDER ENROLLMENT",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871256666",
            "telephone_number": "505-923-6770",
            "fax_number": "505-923-5354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 CHAMA AVE",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875053372",
            "telephone_number": "505-988-2211",
            "fax_number": "303-945-7844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HULTMAN",
        "first_name": "TODD",
        "middle_name": "D.",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-17",
        "last_updated": "2022-01-03",
        "certification_date": "2022-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CO",
            "license": "991803-NP",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "MA",
            "license": "254580",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NM",
            "license": "65648",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "701211",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "69633517",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Fe, NM

Sources for this page

Verify at the official NPI Registry.