NPIMap

Organization Active NPI

St. Vincent Hospital

Doing business as CHRISTUS St. Vincent Plastics and Reconstruction Services

  • Plastic and Reconstructive Surgery Physician
  • Santa Fe, NM
National Provider Identifier
1609218452
Registry record updated Aug 9, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X
Legal business name
ST. VINCENT HOSPITAL
Doing business as
CHRISTUS St. Vincent Plastics and Reconstruction Services
Practice address
465 Saint Michaels Dr
Suite 204
Santa Fe, NM 87505
Phone
(505) 913-3101
NPI assigned
Jul 22, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2018

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

Authorized official

Name
Lillian Montoya
Title
Ceo/President
Phone
(505) 913-5201

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic and Reconstructive Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2086S0122X NM Primary

Addresses

Primary practice location

465 Saint Michaels Dr
Suite 204
Santa Fe, NM 87505

Mailing address

455 St Michaels Dr
Santa Fe, NM 87505-7601
Phone (505) 913-5227

Other names 1

  • CHRISTUS St. Vincent Plastics and Reconstruction Services Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040105000372 NM Part B Supplier - Clinic/Group Practice 6608775135 Receives reassigned benefits from 425 practitioners
This NPI is an additional NPI on the enrollment
Practice locations: Santa Fe, NM; Los Alamos, NM; Albuquerque, NM; Espanola, NM; Farmington, NM; Las Vegas, NM

National Provider Directory

National Provider Directory
Tax ID family
Santa Fe Med Lab28 organizations share this tax ID, including this one

Other organizations with this tax ID 27

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

View all 27

Locations

1631 Hospital Dr
Ste 240
Santa Fe, NM 87505
Phone (505) 913-3975

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1374451200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1533772800000",
    "number": "1609218452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "455 ST MICHAELS DR",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875057601",
            "telephone_number": "505-913-5227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "465 SAINT MICHAELS DR",
            "address_2": "SUITE 204",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "87505",
            "telephone_number": "505-913-3101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. VINCENT HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-07-22",
        "last_updated": "2018-08-09",
        "status": "A",
        "authorized_official_last_name": "MONTOYA",
        "authorized_official_first_name": "LILLIAN",
        "authorized_official_title_or_position": "CEO/PRESIDENT",
        "authorized_official_telephone_number": "505-913-5201"
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "NM",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CHRISTUS St. Vincent Plastics and Reconstruction Services",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "CHRISTUS St. Vincent Plastics and Reconstruction Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Santa Fe, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.