NPIMap

Organization Active NPI

Presbyterian Healthcare Services

Doing business as Presbyterian Kaseman Psych Unit

  • Psychiatric Hospital Unit
  • Albuquerque, NM
National Provider Identifier
1598740482
Registry record updated Jul 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric Hospital UnitTaxonomy code 273R00000X
License
6114 Issued in NM
Legal business name
PRESBYTERIAN HEALTHCARE SERVICES
Doing business as
Presbyterian Kaseman Psych Unit
Practice address
8300 Constitution Ave NE
Albuquerque, NM 87110-7613
Phone
(505) 291-5300
Fax
(505) 291-5301
NPI assigned
Dec 13, 2005
Reactivated
Jul 30, 2015
Last updated
Jul 30, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2015

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

Authorized official

Name
Mr. Dale Maxwell
Title
VP Finance/Cfo Delivery System
Phone
(505) 923-5353

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X
Internal Medicine Physician 207R00000X
Psychiatric Hospital Unit 273R00000X 6114 NM Primary

Addresses

Primary practice location

8300 Constitution Ave NE
Albuquerque, NM 87110-7613

Mailing address

PO Box 26666
Albuquerque, NM 87125-6666
Phone (505) 923-5356

Other identifiers 2

IdentifierTypeStateIssuer
225720 0OtherNMMEDICARE PART B
00993MedicaidNM

Other names 1

  • Presbyterian Kaseman Psych Unit Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040818000466 NM Part A Provider - Hospital 9234041708 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
O20070913000906 NM Part A Provider - Hospital 9234041708 Practice locations: Rio Rancho, NM; Albuquerque, NM

NPI to CCN mapping 3

The Medicare certification numbers (CCNs) connected to NPI 1598740482. Details of each certification follow.

Hospital certification: CCN 320021

Legal name
PRESBYTERIAN HEALTHCARE SERVICES
Doing business as
PRESBYTERIAN HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
May 12, 2023
Beds
623
Ownership / control type
Private (not for profit)
Organization structure
OtherNon-profit
Incorporated
Oct 24, 1908 in NM
Enrollment address
1100 Central Ave SE
Albuquerque, NM 87106-4930
Main/Primary Hospital Location
Hospital subgroups
Acute care

Hospital certification: CCN 32S021

Legal name
PRESBYTERIAN HEALTHCARE SERVICES
Doing business as
PRESBYTERIAN KASEMAN PSYCH UNIT
Organization structure
OtherNon-profit
Incorporated
Oct 24, 1908 in NM
Enrollment address
8300 Constitution Ave NE
Albuquerque, NM 87110-7613
Hospital Psychiatric Unit
Hospital subgroups
Psychiatric unit

Hospital certification: CCN 320079

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
PRESBYTERIAN KASEMAN HOSPITAL
Certification status
Terminated Voluntary: merger or closure, Oct 1, 2006
Provider type (POS)
Hospital – Short-term
Participating since
Apr 1, 1990
Last certification
Jun 15, 2006
Beds
170
Ownership / control type
Private (for profit)
Facility address
8300 Constitution Avenue NE
Albuquerque, NM 87110

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Hospital

Medicare Care Compare
Listed as
Presbyterian HospitalCCN 320021 · All quality measures
Overall star rating
2 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 21

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Angela R Gallegos-Macias Individual OtherBoard of Trustees Jan 1, 2018
Kimberly Poland Individual W-2 Managing EmployeeManager Provider Enrollment Jan 1, 2017
Terri Kline Individual OtherBoard of Trustees Jan 1, 2022
Marjorie J Bessel Individual OtherBoard of Trustees Jan 1, 2022
Rishi Sikka Individual Corporate OfficerCeo/President Oct 1, 2024
W-2 Managing EmployeeCeo/President Oct 1, 2024
OtherBoard of Trustees Oct 1, 2024
Barbara Balik Individual OtherBoard of Trustees Jan 1, 2021
Tom Briones Individual OtherBoard of Trustees Sep 1, 2024
Norman Becker Individual OtherBoard of Trustees Jan 1, 2019
Elisabeth Eden Individual OtherBoard of Trustees Jan 1, 2024
Leslie Hoffman Individual OtherBoard of Trustees Jan 1, 2017
Robert Jefferson Individual OtherBoard of Trustees Aug 1, 2015
Gayle D Chacon Individual OtherBoard of Trustees Jan 1, 2022
Cynthia Schultz Individual OtherBoard of Trustees Feb 1, 2016
Lauren Cates Individual Corporate OfficerExecutive VP/Coo Jan 1, 2023
W-2 Managing EmployeeExecutive VP/Coo Jan 1, 2000
OtherBoard of Trustees Jan 1, 2023
W-2 Managing Employee May 31, 2007
Victoria Carmignani Individual W-2 Managing Employee Apr 1, 2011
Tom Wise Individual OtherBoard of Trustees Sep 1, 2024
Clay Holderman Individual W-2 Managing Employee Apr 1, 2008
Dale Maxwell Individual Corporate Director May 1, 2009
W-2 Managing Employee Apr 1, 2009
David R Scrase Individual Corporate Director Jan 1, 2007
W-2 Managing Employee Jan 1, 2007
Steven Figge Individual W-2 Managing Employee Jan 1, 2010
James Hinton Individual 5% Or Greater Indirect Ownership InterestPresident/Ceo Jan 1, 2000

Owners & managing parties with NPI records 3

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

All facility ownership & control disclosures 9

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Presbyterian Espanola HospitalEspanola, NM, CCN 320011 Hospital Operational/Managerial Control May 24, 1948
Plains Regional Medical Center ClovisClovis, NM, CCN 320022 Hospital Operational/Managerial Control Jan 1, 1978
Socorro General HospitalSocorro, NM, CCN 32Z301 Hospital Operational/Managerial Control Mar 30, 2000
Socorro General HospitalSocorro, NM, CCN 321301 Hospital Operational/Managerial Control Mar 30, 2000
Dr. Dan C. Trigg Memorial HospitalTucumcari, NM, CCN 321302 Hospital Operational/Managerial Control Mar 30, 2000
Dr. Dan C. Trigg Memorial HospitalTucumcari, NM, CCN 32Z302 Hospital Operational/Managerial Control Mar 15, 2000
Socorro General Hospital Home HealthcareSocorro, NM, CCN 327027 Home health agency 5% Or Greater Direct Ownership Interest
Operational/Managerial Control		 Apr 1, 2000
Jan 19, 2009
Plains Regional Medical Center Clovis Home HealthcareClovis, NM, CCN 327305 Home health agency 5% Or Greater Direct Ownership Interest Feb 14, 1979
Tucumcari HospiceTucumcari, NM, CCN 321566 Hospice 5% Or Greater Direct Ownership Interest
Operational/Managerial Control		 Dec 1, 2009
Dec 1, 2009

Practitioners & affiliated clinicians

Practitioners 11

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.

Affiliated clinicians 1,617

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 1,617

NPI Registry JSON

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

{
    "created_epoch": "1134432000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1438214400000",
    "number": "1598740482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 26666",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871256666",
            "telephone_number": "505-923-5356",
            "fax_number": "505-923-5354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8300 CONSTITUTION AVE NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871107613",
            "telephone_number": "505-291-5300",
            "fax_number": "505-291-5301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRESBYTERIAN HEALTHCARE SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-13",
        "last_updated": "2015-07-30",
        "deactivation_date": "2015-06-24",
        "reactivation_date": "2015-07-30",
        "status": "A",
        "authorized_official_last_name": "MAXWELL",
        "authorized_official_first_name": "DALE",
        "authorized_official_title_or_position": "VP FINANCE/CFO DELIVERY SYSTEM",
        "authorized_official_telephone_number": "505-923-5353",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "273R00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Unit",
            "state": "NM",
            "license": "6114",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PART B",
            "identifier": "225720 0",
            "state": "NM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00993",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Presbyterian Kaseman Psych Unit",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.