NPIMap

Organization Active NPI

Presbyterian Healthcare Services

Doing business as Presbyterian Hospital

  • General Acute Care Hospital
  • Albuquerque, NM
National Provider Identifier
1215913470
Registry record updated May 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
6022 Issued in NM
Legal business name
PRESBYTERIAN HEALTHCARE SERVICES
Doing business as
Presbyterian Hospital
Practice address
1100 Central SE
Albuquerque, NM 87106-4930
Phone
(505) 841-1234
Fax
(505) 923-5354
NPI assigned
Dec 20, 2005
Last updated
May 9, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 9, 2019

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

Authorized official

Name
Kimberly Poland
Title
Manager
Phone
(505) 923-5355

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X NU
Internal Medicine Physician 207R00000X NU
Urgent Care Clinic/Center 261QU0200X NU
General Acute Care Hospital 282N00000X 6022 NM Primary

Addresses

Primary practice location

1100 Central SE
Albuquerque, NM 87106-4930

Mailing address

PO Box 26666
Provider Enrollment
Albuquerque, NM 87125-6666
Phone (505) 823-8528

Other identifiers 1

IdentifierTypeStateIssuer
00109MedicaidNM

Other names 1

  • Presbyterian Hospital Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20031103000603 NM Part B Supplier - Clinic/Group Practice 9234041708 Receives reassigned benefits from 2,628 practitioners
13 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
O20040818000466 NM Part A Provider - Hospital 9234041708 1 other NPI on this enrollment

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1215913470. Details of each certification follow.

Hospital certification: CCN 320021

Legal name
PRESBYTERIAN HEALTHCARE SERVICES
Doing business as
PRESBYTERIAN HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
May 12, 2023
Beds
623
Ownership / control type
Private (not for profit)
Organization structure
OtherNon-profit
Incorporated
Oct 24, 1908 in NM
Enrollment address
1100 Central Ave SE
Albuquerque, NM 87106-4930
Main/Primary Hospital Location
Hospital subgroups
Acute care

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs on the same Medicare enrollment 12

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Hospital

Medicare Care Compare
Listed as
Presbyterian HospitalCCN 320021 · All quality measures
Overall star rating
2 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
32D0534945Presbyterian Hospital Laboratory Tricore1100 Central Avenue SE, Albuquerque, NM 87106AccreditationOct 19, 2026

National Provider Directory

National Provider Directory

Locations (25 of 53)

1001 Silver Ave SE
Albuquerque, NM 87106
Phone (505) 224-7000

201 Cedar St SE
Ste 4600
Albuquerque, NM 87106
Phone (505) 563-6450

201 Cedar St SE
Ste 4640
Albuquerque, NM 87106
Phone (505) 563-6530

201 Cedar St SE
Ste 4660
Albuquerque, NM 87106
Phone (505) 563-6530

201 Cedar St SE
Ste 503
Albuquerque, NM 87106
Phone (505) 224-7478

201 Cedar St SE
Ste 5600
Albuquerque, NM 87106
Phone (505) 554-7836

201 Cedar St SE
Ste 6630
Albuquerque, NM 87106
Phone (505) 563-6399

201 Cedar St SE
Ste 6670
Albuquerque, NM 87106
Phone (505) 563-6120

201 Cedar St SE
Ste 820
Albuquerque, NM 87106
Phone (505) 563-6490

4411 The 25 Way NE
Ste 150
Albuquerque, NM 87109
Phone (505) 332-5800

5901 Harper Dr NE
Ste 917
Albuquerque, NM 87109
Phone (505) 823-8020

6000 Forest Hills Dr NE
Albuquerque, NM 87109
Phone (505) 291-2090

6100 Pan American East Fwy NE
Albuquerque, NM 87109
Phone (505) 823-1010

6100 Pan American East Fwy NE
Ste 2
Albuquerque, NM 87109
Phone (505) 823-8020

6100 Pan American East Fwy NE
Ste 200
Albuquerque, NM 87109
Phone (505) 823-8282

6100 Pan American East Fwy NE
Ste 355
Albuquerque, NM 87109
Phone (505) 452-7979

6100 Pan American East Fwy NE
Ste 390
Albuquerque, NM 87109
Phone (505) 823-1805

6100 Pan American East Fwy NE
Ste 450
Albuquerque, NM 87109
Phone (505) 823-1805

6100 Pan American East Fwy NE
Ste 455
Albuquerque, NM 87109
Phone (505) 823-1145

6301 Forest Hills Dr NE
Albuquerque, NM 87109
Phone (505) 823-8399

8100 Constitution Pl NE
Ste 400
Albuquerque, NM 87110
Phone (505) 559-1000

8300 Constitution Ave NE
#D
Albuquerque, NM 87110
Phone (505) 291-2200

8300 Constitution Ave NE
Fl 2
Albuquerque, NM 87110
Phone (505) 291-2770

9201 San Mateo Blvd NE
Albuquerque, NM 87113
Phone (505) 923-5858

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

Ownership & related parties

All disclosed owners & managing parties 16

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Angela R Gallegos-Macias Individual OtherBoard of Trustees Jan 1, 2018
Kimberly Poland Individual W-2 Managing EmployeeManager Provider Enrollment Jan 1, 2017
Terri Kline Individual OtherBoard of Trustees Jan 1, 2022
Marjorie J Bessel Individual OtherBoard of Trustees Jan 1, 2022
Rishi Sikka Individual Corporate OfficerCeo/President Oct 1, 2024
W-2 Managing EmployeeCeo/President Oct 1, 2024
OtherBoard of Trustees Oct 1, 2024
Barbara Balik Individual OtherBoard of Trustees Jan 1, 2021
Tom Briones Individual OtherBoard of Trustees Sep 1, 2024
Norman Becker Individual OtherBoard of Trustees Jan 1, 2019
Elisabeth Eden Individual OtherBoard of Trustees Jan 1, 2024
Leslie Hoffman Individual OtherBoard of Trustees Jan 1, 2017
Robert Jefferson Individual OtherBoard of Trustees Aug 1, 2015
Gayle D Chacon Individual OtherBoard of Trustees Jan 1, 2022
Cynthia Schultz Individual OtherBoard of Trustees Feb 1, 2016
Lauren Cates Individual Corporate OfficerExecutive VP/Coo Jan 1, 2023
W-2 Managing EmployeeExecutive VP/Coo Jan 1, 2000
OtherBoard of Trustees Jan 1, 2023
Victoria Carmignani Individual W-2 Managing Employee Apr 1, 2011
Tom Wise Individual OtherBoard of Trustees Sep 1, 2024

Owners & managing parties with NPI records 2

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

All facility ownership & control disclosures 9

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Presbyterian Espanola HospitalEspanola, NM, CCN 320011 Hospital Operational/Managerial Control May 24, 1948
Plains Regional Medical Center ClovisClovis, NM, CCN 320022 Hospital Operational/Managerial Control Jan 1, 1978
Socorro General HospitalSocorro, NM, CCN 32Z301 Hospital Operational/Managerial Control Mar 30, 2000
Socorro General HospitalSocorro, NM, CCN 321301 Hospital Operational/Managerial Control Mar 30, 2000
Dr. Dan C. Trigg Memorial HospitalTucumcari, NM, CCN 321302 Hospital Operational/Managerial Control Mar 30, 2000
Dr. Dan C. Trigg Memorial HospitalTucumcari, NM, CCN 32Z302 Hospital Operational/Managerial Control Mar 15, 2000
Socorro General Hospital Home HealthcareSocorro, NM, CCN 327027 Home health agency 5% Or Greater Direct Ownership Interest
Operational/Managerial Control		 Apr 1, 2000
Jan 19, 2009
Plains Regional Medical Center Clovis Home HealthcareClovis, NM, CCN 327305 Home health agency 5% Or Greater Direct Ownership Interest Feb 14, 1979
Tucumcari HospiceTucumcari, NM, CCN 321566 Hospice 5% Or Greater Direct Ownership Interest
Operational/Managerial Control		 Dec 1, 2009
Dec 1, 2009

Practitioners & affiliated clinicians

Practitioners 2,696

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.

View all 2,696

Affiliated clinicians 1,617

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 1,617

NPI Registry JSON

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

{
    "created_epoch": "1135036800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1557360000000",
    "number": "1215913470",
    "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": "505-823-8528",
            "fax_number": "505-823-8555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 CENTRAL SE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871064930",
            "telephone_number": "505-841-1234",
            "fax_number": "505-923-5354"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRESBYTERIAN HEALTHCARE SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-20",
        "last_updated": "2019-05-09",
        "status": "A",
        "authorized_official_last_name": "POLAND",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "505-923-5355"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "NM",
            "license": "6022",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00109",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Presbyterian Hospital",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Presbyterian Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.