NPIMap

Individual provider Active NPI

Taylor M. Wade, MD

  • Family Medicine Physician
  • Farmington, NM
National Provider Identifier
1710464482
Registry record updated Jul 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD2021-0451 Issued in NM
Practice address
622 W Maple St Ste B
Farmington, NM 87401-6589
Phone
(505) 327-4867
Fax
(505) 327-5355
NPI assigned
Jul 25, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD2021-0451 NM Primary

Addresses

Primary practice location

622 W Maple St Ste B
Farmington, NM 87401-6589

Mailing address

622 W Maple St Ste B
Farmington, NM 87401-6589
Phone (505) 327-4867

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, NM2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20190815001590 WI Practitioner - Family Practice 9638406523 Reassigns benefits to 1 organization
I20210622001031 NM Practitioner - Family Practice 9638406523 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
San Juan Medical Group PCGroup PAC ID 2264468503, 11 clinicians

Practice addresses (Care Compare)

622 W Maple St
Suite B
Farmington, NM 87401-6589
Phone 5053274867106

Hospital & facility affiliations

  • Guardian Angel Home Health, Inc Home health agency, Farmington, NM, CCN 327184
  • Southwestern Home Health Care, Inc. Home health agency, Farmington, NM, CCN 327145
  • Ricelands Home Health Care and Hospice, LLC Home health agency, Rio Rancho, NM, CCN 327806
  • Basin Home Health Inc Home health agency, Farmington, NM, CCN 327104
  • San Juan Regional Medical Center Inc Hospital, Farmington, NM, CCN 320005
  • Mercy Regional Medical Center Hospital, Durango, CO, CCN 060013

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy24
Melanoma (skin cancer) excision1-10
Removal of skin lesions32
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Health System Corporation Current Accepting new patients
San Juan Medical Group PC Family Medicine CurrentSince Aug 1, 2021 Accepting new patients

Locations

500 W Il Route 22
Barrington, IL 60010
Phone (847) 381-3000

29624 Network Pl
Chicago, IL 60673
Phone (608) 741-7652

348 S Division St
Harvard, IL 60033
Phone (815) 943-1122

2300 N Rockton Ave
Rockford, IL 61103
Phone (815) 971-5510

622 W Maple St
Ste B
Farmington, NM 87401
Phone (505) 327-4867

1000 Mineral Point Ave
Janesville, WI 53548
Phone (608) 261-6868

3524 E Milwaukee St
Janesville, WI 53546
Phone (608) 756-7100

849 Kellogg Ave
Janesville, WI 53546
Phone (608) 755-7960

Interoperability endpoints

  • Direct secure messaging: taylor.wade.1@11485.direct.athenahealth.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 10

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1532476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626912000000",
    "number": "1710464482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "622 W MAPLE ST STE B",
            "city": "FARMINGTON",
            "state": "NM",
            "postal_code": "874016589",
            "telephone_number": "505-327-4867",
            "fax_number": "505-327-5355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "622 W MAPLE ST STE B",
            "city": "FARMINGTON",
            "state": "NM",
            "postal_code": "874016589",
            "telephone_number": "505-327-4867",
            "fax_number": "505-327-5355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WADE",
        "first_name": "TAYLOR",
        "middle_name": "M.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-07-25",
        "last_updated": "2021-07-22",
        "certification_date": "2021-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NM",
            "license": "MD2021-0451",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmington, NM

Sources for this page

Verify at the official NPI Registry.