NPIMap

Organization Active NPI

Presbyterian Healthcare Services

Doing business as Presbyterian Home Healthcare of Northern New Mexico

  • Home Health Agency
  • Santa Fe, NM
National Provider Identifier
1659832947
Registry record updated Mar 28, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
PRESBYTERIAN HEALTHCARE SERVICES
Doing business as
Presbyterian Home Healthcare of Northern New Mexico
Practice address
1400 Chama Ave
Santa Fe, NM 87505
Phone
(505) 988-2211
Fax
(505) 772-7613
NPI assigned
Mar 28, 2019
Last updated
Mar 28, 2019By the provider in NPPES
Organization subpart
Yes
Parent organization
PRESBYTERIAN HEALTHCARE SERVICESAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 28, 2019

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

Authorized official

Name
Kimberly Poland
Title
Manager Provider Enrollment
Phone
(505) 923-5355

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

Primary practice location

1400 Chama Ave
Santa Fe, NM 87505

Mailing address

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

Other names 1

  • Presbyterian Home Healthcare of Northern New Mexico Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20191223001896 NM Part A Provider - Home Health Agency 9234041708 Practice locations: Santa Fe, NM

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1659832947. Details of each certification follow.

Home health agency certification: CCN 327233

Legal name
PRESBYTERIAN HEALTHCARE SERVICES
Doing business as
PRESBYTERIAN HOME HEALTHCARE OF NORTHERN NEW MEXICO
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Mar 18, 2020
Last certification
Mar 18, 2020
Ownership / control type
Non-Profit
Organization structure
CorporationNon-profit
Enrollment address
1400 Chama Ave
Santa Fe, NM 87505-3372
HHA Branch

Care Compare: Home health agency

Medicare Care Compare
Listed as
Presbyterian Home Healthcare of Northern NMCCN 327233 · All quality measures
Overall star rating
4 of 5
Ownership
Non-Profit
Certified
Mar 18, 2020
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
32D2171364Presbyterian Home Healthcare of Northern New1400 Chama Ave, Santa Fe, NM 87505Certificate of waiverAug 28, 2027

National Provider Directory

National Provider Directory
Tax ID family
Colfax Laboratory69 organizations share this tax ID, including this one
Part of
Colfax Laboratory

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Ownership & related parties

All disclosed owners & managing parties 15

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 Corporate DirectorBoard of Directors Jan 1, 2018
Kimberly Poland Individual General Partnership InterestManager Provider Enrollment Jan 1, 2025
W-2 Managing EmployeeManager Provider Enrollment Jan 1, 2011
Terri Kline Individual Corporate DirectorBoard of Directors Jan 1, 2022
Heather Olguin Individual OtherHospice Administrator Jan 1, 2025
Rishi Sikka Individual Corporate DirectorBoard of Directors Oct 1, 2024
Barbara Balik Individual Corporate DirectorBoard of Directors Feb 1, 2021
Lee B Sacks Individual Corporate DirectorBoard of Directors Dec 1, 2024
Tom Briones Individual Corporate DirectorBoard of Directors Sep 1, 2024
Norman Becker Individual Corporate DirectorBoard of Directors Jan 1, 2019
Elisabeth Eden Individual Corporate DirectorBoard of Directors Jan 1, 2024
Ahmed a El-Emawy Individual OtherHospice Medical Director Jan 1, 2025
Robert Jefferson Individual Corporate DirectorBoard of Directors Aug 1, 2015
Mike Canfield Individual Corporate DirectorBoard of Directors Aug 1, 2025
Cynthia Schultz Individual Corporate DirectorBoard of Directors Jan 1, 2016
Tom Wise Individual Corporate DirectorBoard of Directors Sep 1, 2024

Owners & managing parties with NPI records 2

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

Affiliated clinicians 25

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

View all 25

NPI Registry JSON

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

{
    "created_epoch": "1553731200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1553731200000",
    "number": "1659832947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PHS PROVIDER ENROLLMENT",
            "address_2": "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": "1400 CHAMA AVE",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "87505",
            "telephone_number": "505-988-2211",
            "fax_number": "505-772-7613"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRESBYTERIAN HEALTHCARE SERVICES",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PRESBYTERIAN HEALTHCARE SERVICES",
        "enumeration_date": "2019-03-28",
        "last_updated": "2019-03-28",
        "status": "A",
        "authorized_official_last_name": "POLAND",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_title_or_position": "MANAGER PROVIDER ENROLLMENT",
        "authorized_official_telephone_number": "505-923-5355"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Presbyterian Home Healthcare of Northern New Mexico",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Santa Fe, NM

Sources for this page

Verify at the official NPI Registry.