NPIMap

Organization Active NPI

Presbyterian Healthcare Services

Doing business as Presbyterian Hospice

  • Community Based Hospice Care Agency
  • Albuquerque, NM
National Provider Identifier
1245216688
Registry record updated Aug 8, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
License
6529A1INPATIENT Issued in NM
Legal business name
PRESBYTERIAN HEALTHCARE SERVICES
Doing business as
Presbyterian Hospice
Practice address
8100 Constitution PL NE
Suite 120
Albuquerque, NM 87110-7643
Phone
(505) 559-1122
Fax
(505) 559-6067
NPI assigned
Dec 19, 2005
Last updated
Aug 8, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2010

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

Authorized official

Name
Mr. Dale Maxwell
Title
VP Finance/Cfo Delivery System
Phone
(505) 923-5353

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X NU
Internal Medicine Physician 207R00000X NU
Community Based Hospice Care Agency 251G00000X 6529A1INPATIENT NM Primary

Addresses

Primary practice location

8100 Constitution PL NE
Suite 120
Albuquerque, NM 87110-7643

Mailing address

PO Box 26666
Albuquerque, NM 87125-6666
Phone (505) 923-5356

Other identifiers 1

IdentifierTypeStateIssuer
N2677MedicaidNM

Other names 1

  • Presbyterian Hospice Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071127000182 NM Part A Provider - Hospice 9234041708 Practice locations: Albuquerque, NM

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1245216688. Details of each certification follow.

Hospice certification: CCN 321502

Legal name
PRESBYTERIAN HEALTHCARE SERVICES
Certification status
Active
Provider type (POS)
Hospice
Participating since
Apr 17, 1984
Last certification
Oct 19, 2021
Ownership / control type
Non-Profit - Private
Organization structure
OtherProprietary
Enrollment address
8100 Constitution Place NE
Suite 400
Albuquerque, NM 87110-7644

Care Compare: Hospice

Medicare Care Compare
Listed as
Presbyterian Hospice Inpatient UnitCCN 321502 · All quality measures
Ownership
Non-Profit
Certified
Apr 17, 1984
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory
Tax ID family
Uzma Hannan MD69 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

8100 Constitution Pl NE
Ste 120
Albuquerque, NM 87110
Phone (505) 559-1122

Ownership & related parties

All disclosed owners & managing parties 5

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

NameRoleSinceShare
Kimberly Poland Individual W-2 Managing EmployeeProvider Enrollment Manager Jan 1, 2011
Heather Olguin Individual W-2 Managing EmployeeAd; Jan 1, 2025
Ahmed a El-Emawy Individual W-2 Managing EmployeeMD; Jan 1, 2025
Steven Figge Individual Corporate DirectorDirector Mso Jan 1, 2001
W-2 Managing EmployeeDirector Mso Jan 1, 2001
Rosemary Coyne Individual Corporate DirectorDirector Hospice Jul 1, 2018

Owners & managing parties with NPI records 1

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 1

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.

Affiliated clinicians 6

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

NPI Registry JSON

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

{
    "created_epoch": "1134950400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1281225600000",
    "number": "1245216688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 26666",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871256666",
            "telephone_number": "505-923-5356",
            "fax_number": "505-923-5354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8100 CONSTITUTION PL NE",
            "address_2": "SUITE 120",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871107643",
            "telephone_number": "505-559-1122",
            "fax_number": "505-559-6067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRESBYTERIAN HEALTHCARE SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-19",
        "last_updated": "2010-08-08",
        "status": "A",
        "authorized_official_last_name": "MAXWELL",
        "authorized_official_first_name": "DALE",
        "authorized_official_title_or_position": "VP FINANCE/CFO DELIVERY SYSTEM",
        "authorized_official_telephone_number": "505-923-5353",
        "authorized_official_name_prefix": "Mr."
    },
    "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": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "NM",
            "license": "6529A1INPATIENT",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "N2677",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Presbyterian Hospice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.