Picuris Medical Center

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

PICURIS MEDICAL CENTER

Practice address

201 K 2 Buffalo Trail
Penasco, NM 87553

Phone

(575) 281-8010

Fax

(833) 438-5215

NPI assigned

Feb 4, 2026

Last updated

Apr 8, 2026By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Patrick Martnez

Title

Director of Pharmacy

Phone

(505) 930-1136

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Picuris Medical Center2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Picuris Medical Center

  • Dentist
  • Penasco, NM
  • NPI 1598561318
  NPD tax ID

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Rachel Pyne

  • Community Health Worker
  • Taos, NM
  • NPI 1164069662
  NPD

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

{
    "created_epoch": "1770163200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1775606400000",
    "number": "1467303685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 K 2 BUFFALO TRAIL",
            "city": "PENASCO",
            "state": "NM",
            "postal_code": "87553",
            "telephone_number": "575-281-8010",
            "fax_number": "833-438-5215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 K 2 BUFFALO TRAIL",
            "city": "PENASCO",
            "state": "NM",
            "postal_code": "87553",
            "telephone_number": "575-281-8010",
            "fax_number": "833-438-5215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PICURIS MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-02-04",
        "last_updated": "2026-04-08",
        "certification_date": "2026-04-08",
        "status": "A",
        "authorized_official_last_name": "MARTNEZ",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_title_or_position": "DIRECTOR OF PHARMACY",
        "authorized_official_telephone_number": "505-930-1136"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "N0052683",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shannon Monique Medina
• Rachel Moore, RDH
• Douglas A. North, PA-C
• Mia G Pacheco, LMSW
• Penasco Independent Schools
• Picuris Medical Center
• Picuris Pueblo
• Sandra Sue Richardson
• Kay-Mani Riely
• Roberta Rodriguez

• Community/Retail Pharmacy in Penasco, NM
• Providers in Penasco, NM by specialty
• Community/Retail Pharmacy in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 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.