Individual provider Active NPI

Theresa Christine Smith, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • Santa Fe, NM
National Provider Identifier
1538459672
Registry record updated Jul 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
2014-0851 Issued in NM
Practice address
455 Saint Michaels Dr
Santa Fe, NM 87505-7601
Phone
(505) 820-5202
NPI assigned
Apr 11, 2011
Last updated
Jul 19, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 2014-0851 NM Primary

Addresses

Primary practice location

455 Saint Michaels Dr
Santa Fe, NM 87505-7601

Mailing address

460 Saint Michaels Dr
Suite 903
Santa Fe, NM 87505-7619
Phone (505) 986-8620

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160518001225 NM Practitioner - Pathology 0042509853 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Santa Fe Pathology Services PAGroup PAC ID 6709820285, 4 clinicians

Practice addresses (Care Compare)

455 Saint Michaels Dr
Santa Fe, NM 87505-7601
Phone (505) 986-8620

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2014-0851NMMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Santa Fe Pathology Services PA Anatomic Pathology & Clinical Pathology CurrentSince Jul 1, 2016 Accepting new patients
Taos Health Systems, Inc., Holy Cross Hospital Past Accepting new patients

Locations

3917 West Rd
Los Alamos, NM 87544
Phone (505) 661-9584

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

455 Saint Michaels Dr
Ste 903
Santa Fe, NM 87505

460 Saint Michaels Dr
Ste 903
Santa Fe, NM 87505
Phone (505) 986-0910

1397 Weimer Rd
Taos, NM 87571
Phone (575) 751-5746

Organizations & group practices 2

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 5

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": "1302480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468886400000",
    "number": "1538459672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "460 SAINT MICHAELS DR",
            "address_2": "SUITE 903",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875057619",
            "telephone_number": "505-986-8620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "455 SAINT MICHAELS DR",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875057601",
            "telephone_number": "505-820-5202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "THERESA",
        "middle_name": "CHRISTINE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-04-11",
        "last_updated": "2016-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "NM",
            "license": "2014-0851",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Fe, NM

Sources for this page

Verify at the official NPI Registry.