Kristin L Graziano, DO
Individual provider Active NPI Family Medicine Physician · Questa, NM
NPI 1407899180 · NPPES record last updated Jul 13, 2021
Key facts
- NPI
- 1407899180
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- A-2341-20 (NM)
- Practice address
- 2573 NM-522
Questa, NM 87556-0290 - Phone
- (575) 586-0315
- NPI assigned
- Jun 13, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 8
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in TX, NM
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100824000262 | TX | Practitioner - Family Practice |
4587788807 | Reassigns benefits to 1 organization |
| I20201013000364 | NM | Practitioner - Family Practice | 4587788807 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20A6664 | CA | MD | Family Medicine Physician |
| A-2341-20 | NM | MD | Family Medicine Physician |
| 6664 | CA | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Presbyterian Medical Services | Current |
Accepting new patients | |
| Presbyterian Medical Services | Current |
Accepting new patients | |
| Presbyterian Medical Services | Current | Accepting new patients | |
| Presbyterian Medical Services | Family Medicine | Past | Accepting new patients |
| Jicarilla IHS Pharmacy | Past |
Accepting new patients | |
| Kayenta Alternative Rural Hospital | Past | Accepting new patients | |
| Taos Health Systems, Inc., Holy Cross Hospital | Past | Accepting new patients |
Locations
1422 Paseo de Peralta
Santa Fe, NM 87501
Phone (505) 982-5565
1775 Hopewell St
Santa Fe, NM 87505
Phone (505) 443-3100
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 20A6664 | CA | |
| Family Medicine Physician | 207Q00000X | A-2341-20 | NM | Yes |
Addresses
Primary practice location
2573 NM-522
Questa, NM 87556-0290
Mailing address
PO Box 290
Questa, NM 87556-0290
Phone (575) 586-0315
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 721284 | Medicaid | AZ |
Other providers in Questa, NM
- Albert E Crusco
- Cynthia Ann Ewers
- Isabel Florko
- Cherlon R Gano
- Jose Adrian Gonzalez
- Harbors Counseling LLC
- Tamaki Anne Harrold
- Susan M Haugen
- Suzanne Kiermont
- Audrey Laws
All providers in Questa, NM · Family Medicine Physician in New Mexico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 13, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.