NPIMap

Organization Active NPI

St Vincent Hospital

  • Obstetrics & Gynecology Physician
  • Santa Fe, NM
National Provider Identifier
1285829366
Registry record updated Jun 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
Legal business name
ST VINCENT HOSPITAL
Practice address
465 Saint Michaels Dr
Suite 202
Santa Fe, NM 87505
Phone
(505) 984-0303
Fax
(505) 984-1116
NPI assigned
Sep 11, 2007
Organization subpart
Yes
Parent organization
ST. VINCENT HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 11, 2020

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

Authorized official

Name
Lillian Montoya
Title
President & Ceo
Phone
(505) 913-5202

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207V00000X Primary

Addresses

Primary practice location

465 Saint Michaels Dr
Suite 202
Santa Fe, NM 87505

Mailing address

2055 S Pacheco St Ste 300
Santa Fe, NM 87505-0504
Phone (505) 984-0303

Other identifiers 1

IdentifierTypeStateIssuer
84074043MedicaidNM

Other names 1

  • CHRISTUS St. Vincent Women's Care Specialists Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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 Directory
Part of
St Vincent Hospital

Practitioners & affiliated clinicians

Practitioners 14

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1189468800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1591833600000",
    "number": "1285829366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2055 S PACHECO ST STE 300",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875050504",
            "telephone_number": "505-984-0303",
            "fax_number": "505-984-1116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "465 SAINT MICHAELS DR",
            "address_2": "SUITE 202",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "87505",
            "telephone_number": "505-984-0303",
            "fax_number": "505-984-1116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST VINCENT HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ST. VINCENT HOSPITAL",
        "enumeration_date": "2007-09-11",
        "last_updated": "2020-06-11",
        "certification_date": "2020-06-11",
        "status": "A",
        "authorized_official_last_name": "MONTOYA",
        "authorized_official_first_name": "LILLIAN",
        "authorized_official_title_or_position": "PRESIDENT & CEO",
        "authorized_official_telephone_number": "505-913-5202"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "84074043",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CHRISTUS St. Vincent Women's Care Specialists",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "CHRISTUS St. Vincent Women's Care Specialists",
            "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 Jun 11, 2020; 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.