Active NPI
St. Vincent Hospital
Doing business as St Vincent Hospital Surgical Group
- Surgery Physician
- Santa Fe, NM
National Provider Identifier
1679690762
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- Legal business name
- ST. VINCENT HOSPITAL
- Doing business as
- St Vincent Hospital Surgical Group
- Practice address
- 1631 Hospital Dr
Suite 240
Santa Fe, NM 87505-4728 - Phone
- (505) 954-8720
- Fax
- (505) 954-8721
- NPI assigned
- Mar 23, 2007
- Last updated
- Nov 2, 2018
- Organization subpart
- Yes
- Parent organization
- ST. VINCENT REGIONAL MEDICAL CENTER
NPPES NPI Registry
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) 913-5258
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | NU | Primary |
Addresses
Primary practice location
1631 Hospital Dr
Suite 240
Santa Fe, NM 87505-4728
Mailing address
455 Saint Michaels Dr
Medical Staff Office
Santa Fe, NM 87505-7601
Phone (505) 820-5227
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| G9515 | Medicaid | NM |
Other names 1
- St Vincent Hospital Surgical Group
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NM
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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- Part of
- William F Johnson
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174608000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1541116800000",
"number": "1679690762",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "455 SAINT MICHAELS DR",
"address_2": "MEDICAL STAFF OFFICE",
"city": "SANTA FE",
"state": "NM",
"postal_code": "875057601",
"telephone_number": "505-820-5227",
"fax_number": "505-820-5440"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1631 HOSPITAL DR",
"address_2": "SUITE 240",
"city": "SANTA FE",
"state": "NM",
"postal_code": "875054728",
"telephone_number": "505-954-8720",
"fax_number": "505-954-8721"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ST. VINCENT HOSPITAL",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "ST. VINCENT REGIONAL MEDICAL CENTER",
"enumeration_date": "2007-03-23",
"last_updated": "2018-11-02",
"status": "A",
"authorized_official_last_name": "MONTOYA",
"authorized_official_first_name": "LILLIAN",
"authorized_official_title_or_position": "CEO PRESIDENT",
"authorized_official_telephone_number": "505-913-5258"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "G9515",
"state": "NM"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "St Vincent Hospital Surgical Group",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "St Vincent Hospital Surgical Group",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Santa Fe, NM
- St. Vincent Hospital (CHRISTUS St. Vincent Physical Medicine and Rehabilitation Specialists)
- St. Vincent Hospital (CHRISTUS St. Vincent Regional Medical Center)
- St. Vincent Hospital (St. Vincent Pediatric Hospitalist Group)
- St. Vincent Hospital (Diabetes Center of Excellence)
- St. Vincent Hospital (Arroyo Chamiso Pediatric Center)
- St. Vincent Hospital (CHRISTUS St. Vincent DeVargas Family Medicine)
- St. Vincent Hospital (Outpatient Behavioral Clinic)
- St. Vincent Hospital (CHRISTUS St. Vincent Palliative Care)
- St. Vincent Hospital (CHRISTUS St. Vincent Heart and Vascular Center)
- St. Vincent Hospital (CHRISTUS St. Vincent Behavioral Health Specialists)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 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.