NPIMap

Organization Active NPI

New Mexico Wic Program

  • Public Health or Welfare Agency
  • Santa Fe, NM
National Provider Identifier
1376464594
Registry record updated Jul 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Public Health or Welfare AgencyTaxonomy code 251K00000X
Legal business name
NEW MEXICO WIC PROGRAM
Practice address
2040 S Pacheco St
Santa Fe, NM 87505-5472
Phone
(505) 476-8800
Fax
(505) 476-8900
NPI assigned
Jul 23, 2026
Organization subpart
Yes
Parent organization
STATE OF NEW MEXICOAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 30, 2026

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

Authorized official

Name
Michelle D Cisneros
Title
Medicaid Managed Care Contracts
Phone
(505) 623-1256

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health or Welfare Agency 251K00000X Primary

Addresses

Primary practice location

2040 S Pacheco St
Santa Fe, NM 87505-5472

Mailing address

2040 S Pacheco St
Santa Fe, NM 87505-5472
Phone (505) 476-8800

Other names 1

  • New Mexico WIC Program Other name

National Provider Directory

National Provider Directory
Tax ID family
Scientific Laboratory Division Nmdoh43 organizations share this tax ID, including this one

Other organizations with this tax ID 42

Organizations that report the same tax identification number in the National Provider Directory.

View all 42

NPI Registry JSON

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

{
    "created_epoch": "1784764800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1785369600000",
    "number": "1376464594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2040 S PACHECO ST",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875055472",
            "telephone_number": "505-476-8800",
            "fax_number": "505-476-8900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2040 S PACHECO ST",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875055472",
            "telephone_number": "505-476-8800",
            "fax_number": "505-476-8900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW MEXICO WIC PROGRAM",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "STATE OF NEW MEXICO",
        "enumeration_date": "2026-07-23",
        "last_updated": "2026-07-30",
        "certification_date": "2026-07-30",
        "status": "A",
        "authorized_official_last_name": "CISNEROS",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "MEDICAID MANAGED CARE CONTRACTS",
        "authorized_official_telephone_number": "505-623-1256"
    },
    "taxonomies": [
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "New Mexico WIC Program",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 Jul 30, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.