NPIMap

Organization Active NPI

La Clinica del Pueblo de Rio Arriba

  • Land Ambulance
  • Tierra Amarilla, NM
National Provider Identifier
1215129291
Registry record updated Dec 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Land AmbulanceTaxonomy code 3416L0300X
Legal business name
LA CLINICA DEL PUEBLO DE RIO ARRIBA
Practice address
#14 County Rd 0324 Highway 84
Tierra Amarilla, NM 87575
Phone
(575) 588-7252
Fax
(575) 588-9132
NPI assigned
Aug 14, 2007
Last updated
Dec 8, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2023

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

Authorized official

Name
Ms. Paula G Gurule
Title
Interim Executive Director
Phone
(575) 588-7252

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Land Ambulance 3416L0300X Primary

Addresses

Primary practice location

#14 County Rd 0324 Highway 84
Tierra Amarilla, NM 87575

Mailing address

PO Box 250
Hwy 84, County Rd 0324, #14
Tierra Amarilla, NM 87575-0250
Phone (575) 588-7252

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050126000763 NM Part B Supplier - Ambulance Service Supplier 9638148018 Practice locations: Tierra Amarilla, NM

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
La Clinica del Pueblo de Rio Arriba3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/HFHCBA

Practitioners & affiliated clinicians

Practitioners 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1187049600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701993600000",
    "number": "1215129291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 250",
            "address_2": "HWY 84, COUNTY RD 0324, #14",
            "city": "TIERRA AMARILLA",
            "state": "NM",
            "postal_code": "875750250",
            "telephone_number": "575-588-7252",
            "fax_number": "575-588-9132"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "#14 COUNTY RD 0324 HIGHWAY 84",
            "city": "TIERRA AMARILLA",
            "state": "NM",
            "postal_code": "87575",
            "telephone_number": "575-588-7252",
            "fax_number": "575-588-9132"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LA CLINICA DEL PUEBLO DE RIO ARRIBA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-14",
        "last_updated": "2023-12-08",
        "certification_date": "2023-12-08",
        "status": "A",
        "authorized_official_last_name": "GURULE",
        "authorized_official_first_name": "PAULA",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "INTERIM EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "575-588-7252",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tierra Amarilla, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.