Active NPI
Alston C Lundgren, M.D.
- Family Medicine Physician
- Santa Fe, NM
National Provider Identifier
1609808005
On this page
OIG exclusion record
The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:
- Section 1128b(4) exclusion effective Feb 18, 2016.
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 98-323
- Practice address
- 460 Saint Michaels Dr
Ste. 801
Santa Fe, NM 87505-7619 - Phone
- (505) 986-0910
- Fax
- (505) 986-0904
- NPI assigned
- Jul 7, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 98-323 | NM | Primary |
Addresses
Primary practice location
460 Saint Michaels Dr
Ste. 801
Santa Fe, NM 87505-7619
Mailing address
460 St. Michael'S Dr.
Ste. 801
Santa Fe, NM 87505
Phone (505) 986-0910
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 76885 | Medicaid | NM |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152230400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1609808005",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "460 ST. MICHAEL'S DR.",
"address_2": "STE. 801",
"city": "SANTA FE",
"state": "NM",
"postal_code": "87505",
"telephone_number": "505-986-0910",
"fax_number": "505-986-0904"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "460 SAINT MICHAELS DR",
"address_2": "STE. 801",
"city": "SANTA FE",
"state": "NM",
"postal_code": "875057619",
"telephone_number": "505-986-0910",
"fax_number": "505-986-0904"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LUNDGREN",
"first_name": "ALSTON",
"middle_name": "C",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-07",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "NM",
"license": "98-323",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "76885",
"state": "NM"
}
],
"endpoints": [],
"other_names": []
}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 Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.