Boudinot T Atterbury, MD
Individual provider Active NPI Internal Medicine Physician · Santa Fe, NM
NPI 1720006448 · NPPES record last updated Jul 2, 2013
Key facts
- NPI
- 1720006448
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- 88112 (NM)
- Practice address
- 1691 Galisteo St
Suite D
Santa Fe, NM 87505-4780 - Phone
- (505) 954-1921
- Fax
- (505) 954-1922
- NPI assigned
- Jul 18, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 11
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Internal Medicine
- Education
- JS Weill Medical College, Cornell University, 1984
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- St Vincent Hospital
Practice addresses (Care Compare)
455 Saint Michaels Dr
Santa Fe, NM 87505-7601
Phone (505) 913-6130
Hospital & facility affiliations
- Christus St Vincent Regional Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NM
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20080718000314 | NM | Practitioner - Internal Medicine | 0143267369 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 88112 | NM | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St Vincent Hospital | Current |
Accepting new patients | |
| St. Vincent Hospital | Current |
Accepting new patients | |
| St Vincent Hospital | Current | Accepting new patients | |
| Adult Medicine Specialists of Santa Fe | Internal Medicine | Past |
Accepting new patients |
Locations
1631 Hospital Dr
Ste 240
Santa Fe, NM 87505
Phone (505) 913-3975
455 Saint Michaels Dr
Santa Fe, NM 87505
Phone (505) 913-3361
465 Saint Michaels Dr
Ste 200
Santa Fe, NM 87505
Phone (505) 995-4901
465 Saint Michaels Dr
Ste 200
Santa Fe, NM 87505
Phone (505) 995-4901
Interoperability endpoints
- batterbury165462@christushealth.direct-ci.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 88112 | NM | Yes |
Addresses
Primary practice location
1691 Galisteo St
Suite D
Santa Fe, NM 87505-4780
Mailing address
1691 Galisteo St
Suite D
Santa Fe, NM 87505-4780
Phone (505) 954-1921
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 30751 | Medicaid | NM | |
| 201000365 | Other | NM | PRESBYTERIAN |
| NM013461 | Other | NM | BCBS |
Other providers in Santa Fe, NM
- Sabrina Atencio
- Christopher Dean Atkinson
- Julie K Atkinson
- Nora Kathleen Atkinson
- Heather Atsye
- Attuned Hearts LLC
- James H Auerbach
- Nina Augustine
- Xena Augustine
- Glory P Auldon
All providers in Santa Fe, NM · Internal Medicine Physician in New Mexico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 2, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.