Active NPI
Stephanie V Lucero, M.D.
- Family Medicine Physician
- Santa Fe, NM
National Provider Identifier
1740570175
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- MD2013-0783
- Practice address
- 1713 NM 502
Santa Fe, NM 87506-8931 - Phone
- (505) 557-4551
- Fax
- (505) 557-4552
- NPI assigned
- Apr 19, 2011
- Last updated
- Jul 6, 2019
- Sex
- Female
- Sole proprietor
- Yes
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 | MD2013-0783 | NM | Primary |
Addresses
Primary practice location
1713 NM 502
Santa Fe, NM 87506-8931
Mailing address
1713 NM 502
Santa Fe, NM 87506-8931
Phone (505) 557-4551
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Nov 20, 2018 through Nov 20, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD2013-0783 | NM | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Taos Health Systems, Inc., Holy Cross Hospital | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Critical Access Hospital
- Taos, NM
- NPI 1902338049
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1303171200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1562371200000",
"number": "1740570175",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1713 NM 502",
"city": "SANTA FE",
"state": "NM",
"postal_code": "875068931",
"telephone_number": "505-557-4551",
"fax_number": "505-557-4552"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1713 NM 502",
"city": "SANTA FE",
"state": "NM",
"postal_code": "875068931",
"telephone_number": "505-557-4551",
"fax_number": "505-557-4552"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LUCERO",
"first_name": "STEPHANIE",
"middle_name": "V",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-04-19",
"last_updated": "2019-07-06",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "NM",
"license": "MD2013-0783",
"primary": true
}
],
"identifiers": [],
"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 6, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.