NPIMap

Individual provider Active NPI

Ilango Dharmarajan, AGPCNP-BC

  • Adult Health Nurse Practitioner
  • Santa Fe, NM
National Provider Identifier
1528526464
Registry record updated Sep 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
55465 Issued in NM
Practice address
465 Saint Michaels Dr Ste 116
Santa Fe, NM 87505-7621
Phone
(505) 984-2600
NPI assigned
Mar 11, 2019
Last updated
Sep 24, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 55465 NM Primary
Gerontology Nurse Practitioner 363LG0600X 55465 NM

Addresses

Primary practice location

465 Saint Michaels Dr Ste 116
Santa Fe, NM 87505-7621

Mailing address

465 Saint Michaels Dr Ste 230
Santa Fe, NM 87505-8602
Phone (505) 913-4710

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190722002246 NM Practitioner - Nurse Practitioner 3375879893 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
St Vincent HospitalGroup PAC ID 6608775135, 335 clinicians

Practice addresses (Care Compare)

2025 Galisteo St
Suite a
Santa Fe, NM 87505-2101
Phone (505) 913-3450

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St. Vincent Hospital Current Accepting new patients
St. Vincent Hospital CurrentSince Jun 24, 2019 Accepting new patients
St Vincent Hospital Current Accepting new patients
St. Vincent Hospital CurrentSince Jun 24, 2019 Accepting new patients

Locations

2025 Galisteo St
Ste A
Santa Fe, NM 87505
Phone (505) 913-3450

455 Saint Michaels Dr
Santa Fe, NM 87505
Phone (505) 913-3361

465 Saint Michaels Dr
Ste 116
Santa Fe, NM 87505
Phone (505) 913-4260

465 Saint Michaels Dr
Ste 200
Santa Fe, NM 87505
Phone (505) 995-4901

465 Saint Michaels Dr
Ste 200
Santa Fe, NM 87505
Phone (505) 995-4901

465 Saint Michaels Dr
Ste 230
Santa Fe, NM 87505
Phone (505) 913-4710

5 Petroglyph Cir
Ste A
Santa Fe, NM 87506
Phone (505) 455-1962

Interoperability endpoints

  • Direct secure messaging: idharmarajan163836@christushealth.direct-ci.net

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1552262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663977600000",
    "number": "1528526464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "465 SAINT MICHAELS DR STE 230",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875058602",
            "telephone_number": "505-913-4710",
            "fax_number": "505-913-4711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "465 SAINT MICHAELS DR STE 116",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875057621",
            "telephone_number": "505-984-2600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DHARMARAJAN",
        "first_name": "ILANGO",
        "name_prefix": "Mr.",
        "credential": "AGPCNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-11",
        "last_updated": "2022-09-24",
        "certification_date": "2022-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NM",
            "license": "55465",
            "primary": true
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "NM",
            "license": "55465",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Fe, NM

Sources for this page

Verify at the official NPI Registry.