Terese Aileen O'Neil Selvage, MN, CNP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

R36675 Issued in NM

Practice address

1160 Camino de Cruz Blanca
Santa Fe, NM 87505-4584

Phone

(505) 984-6418

Fax

(505) 984-6918

NPI assigned

Sep 21, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Terese Aileen O'Neil Former name

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

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner, Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: terese.selvage.1@2913.direct.athenahealth.com

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.

• Southwest Care Center

  • Federally Qualified Health Center (FQHC)
  • Santa Fe, NM
  • NPI 1871602698
  Medicare reassignment NPD
• Southwest Care Center

  • Federally Qualified Health Center (FQHC)
  • Santa Fe, NM
  • NPI 1295109072
  NPD
• St Johns College Health Center

  • Nurse Practitioner
  • Santa Fe, NM
  • NPI 1649537978
  NPD (past)

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

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705449600000",
    "number": "1205935004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6880",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875026880",
            "telephone_number": "505-216-0332",
            "fax_number": "505-982-0279"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1160 CAMINO DE CRUZ BLANCA",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875054584",
            "telephone_number": "505-984-6418",
            "fax_number": "505-984-6918"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SELVAGE",
        "first_name": "TERESE",
        "middle_name": "AILEEN O'NEIL",
        "credential": "MN, CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-21",
        "last_updated": "2024-01-17",
        "certification_date": "2024-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NM",
            "license": "CNP00790",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NM",
            "license": "R36675",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TERESE",
            "last_name": "O'NEIL",
            "middle_name": "AILEEN",
            "credential": "MN, CNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Michelle Segura
• Gurbax Singh Sekhon, PH.D
• Mana Selan
• Bettina Sellers, DOM
• Katherine D Seluja, CPNP
• Walter David Selvage, PA-C
• Desiree Sena
• Laura Sena
• Vanessa Sena, DDS
• Gal Senderowitsch, INTER MENTAL HEALTH

• Adult Health Nurse Practitioner in Santa Fe, NM
• Providers in Santa Fe, NM by specialty
• Adult Health Nurse Practitioner in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.