Active NPI
Dermatology Partners of Northern New Mexico
- Dermatology Physician
- Santa Fe, NM
National Provider Identifier
1245752005
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- Legal business name
- DERMATOLOGY PARTNERS OF NORTHERN NEW MEXICO
- Practice address
- 1651 Galisteo St Ste 5
Santa Fe, NM 87505-4752 - Phone
- (505) 983-0286
- Fax
- (505) 983-0286
- NPI assigned
- Jul 13, 2017
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Angela Heath
- Title
- Office Manager
- Phone
- (505) 983-0286
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | NM | Primary |
Addresses
Primary practice location
1651 Galisteo St Ste 5
Santa Fe, NM 87505-4752
Mailing address
1651 Galisteo St. Suite 5
Santa Fe, NM 87505
Phone (505) 983-0286
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 03-381199-00-7 | Other | NM | CRS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NM
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20170814000729 | NM | Part B Supplier - Clinic/Group Practice | 5496026270 |
Receives reassigned benefits from 5 practitioners Practice locations: Santa Fe, NM |
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 5
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1499904000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1658361600000",
"number": "1245752005",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1651 GALISTEO ST. SUITE 5",
"city": "SANTA FE",
"state": "NM",
"postal_code": "87505",
"telephone_number": "505-983-0286"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1651 GALISTEO ST STE 5",
"city": "SANTA FE",
"state": "NM",
"postal_code": "875054752",
"telephone_number": "505-983-0286",
"fax_number": "505-983-0286"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "DERMATOLOGY PARTNERS OF NORTHERN NEW MEXICO",
"organizational_subpart": "NO",
"enumeration_date": "2017-07-13",
"last_updated": "2022-07-21",
"status": "A",
"authorized_official_last_name": "HEATH",
"authorized_official_first_name": "ANGELA",
"authorized_official_title_or_position": "OFFICE MANAGER",
"authorized_official_telephone_number": "505-983-0286"
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Dermatology",
"state": "NM",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CRS",
"identifier": "03-381199-00-7",
"state": "NM"
}
],
"endpoints": [],
"other_names": []
}Other providers in Santa Fe, NM
- Department of Health - Public Health Division
- Department of Health, Public Health Division
- Department of Health, Public Health Division
- Department of Health, Public Health Division
- Dermatology of Santa Fe PC
- Kendall Derosso
- Desert Mountain Skin Cancer Surgery, LLC
- Desert Rain Chiropractic
- Desert Rain Midwifery, LLC
- Desert Resilience Counseling LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.