Active NPI
St. Vincent Hospital
- Neurological Surgery Physician
- Santa Fe, NM
National Provider Identifier
1265611396
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurological Surgery Physician
- Legal business name
- ST. VINCENT HOSPITAL
- Practice address
- 1631 Hospital Dr
Suite 240
Santa Fe, NM 87505-4728 - Phone
- (505) 946-3220
- Fax
- (505) 946-3128
- NPI assigned
- Oct 25, 2007
- 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
- J Alex Valdez
- Title
- President/Ceo
- Phone
- (505) 820-5202
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neurological Surgery Physician | 207T00000X | Primary |
Addresses
Primary practice location
1631 Hospital Dr
Suite 240
Santa Fe, NM 87505-4728
Mailing address
455 Saint Michaels Dr
Medical Staff Office
Santa Fe, NM 87505-7601
Phone (505) 946-3220
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 46537520 | Medicaid | NM |
Other names 1
- St. Vincent Regional Spine Center
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NM
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040105000372 | NM | Part B Supplier - Clinic/Group Practice | 6608775135 |
Receives reassigned benefits from 425 practitioners This NPI is an additional NPI on the enrollment Practice locations: Santa Fe, NM; Los Alamos, NM; Albuquerque, NM; Espanola, NM; Farmington, NM; Las Vegas, NM |
National Provider Directory
National Provider DirectoryLocations
455 Saint Michaels Dr
Ofc
Santa Fe, NM 87505
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1193270400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1265846400000",
"number": "1265611396",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "455 SAINT MICHAELS DR",
"address_2": "MEDICAL STAFF OFFICE",
"city": "SANTA FE",
"state": "NM",
"postal_code": "875057601",
"telephone_number": "505-946-3220",
"fax_number": "505-946-3128"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1631 HOSPITAL DR",
"address_2": "SUITE 240",
"city": "SANTA FE",
"state": "NM",
"postal_code": "875054728",
"telephone_number": "505-946-3220",
"fax_number": "505-946-3128"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ST. VINCENT HOSPITAL",
"organizational_subpart": "NO",
"enumeration_date": "2007-10-25",
"last_updated": "2010-02-11",
"status": "A",
"authorized_official_last_name": "VALDEZ",
"authorized_official_first_name": "J",
"authorized_official_middle_name": "ALEX",
"authorized_official_title_or_position": "PRESIDENT/CEO",
"authorized_official_telephone_number": "505-820-5202"
},
"taxonomies": [
{
"code": "207T00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Neurological Surgery",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "46537520",
"state": "NM"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "St. Vincent Regional Spine Center",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Santa Fe, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2010; 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.