Timothy J Vanderjagt, M.D.

Primary specialty

Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X

License

MD2007-0397 Issued in NM

Practice address

455 Saint Michaels Dr
Santa Fe, NM 87505-7601

Phone

(505) 820-5274

NPI assigned

Aug 15, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NM

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Pathology

Education

University of New Mexico School of Medicine, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Santa Fe Pathology Services PAGroup PAC ID 6709820285, 4 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Christus St Vincent Regional Medical Center Hospital, Santa Fe, NM, CCN 320002
• Holy Cross Hospital a Div of Taos Health Systems Hospital, Taos, NM, CCN 321310
• Los Alamos Medical Center Hospital, Los Alamos, NM, CCN 320033

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as group

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Santa Fe Pathology Services PA

  • Anatomic Pathology & Clinical Pathology Physician
  • Santa Fe, NM
  • NPI 1043308810
  Medicare reassignment Care Compare group NPD Authorized official

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

• PHC-Los Alamos Inc

  • Rural Acute Care Hospital
  • Los Alamos, NM
  • NPI 1285701623
  Care Compare affiliation
• St Vincent Hospital

  • General Acute Care Hospital
  • Santa Fe, NM
  • NPI 1578587150
  Care Compare affiliation
• Taos Health Systems Inc Holy Cross Hospital

  • General Acute Care Hospital
  • Taos, NM
  • NPI 1194751958
  Care Compare affiliation
• Taos Health Systems, Inc., Holy Cross Hospital

  • Critical Access Hospital
  • Taos, NM
  • NPI 1902338049
  Care Compare affiliation

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

{
    "created_epoch": "1187136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210291200000",
    "number": "1780876540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "465 SAINT MICHAELS DR",
            "address_2": "SUITE 115",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875057670",
            "telephone_number": "505-986-8620",
            "fax_number": "505-820-2461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "455 SAINT MICHAELS DR",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875057601",
            "telephone_number": "505-820-5274"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDERJAGT",
        "first_name": "TIMOTHY",
        "middle_name": "J",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-15",
        "last_updated": "2008-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "NM",
            "license": "MD2007-0397",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "21079021",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF NM",
            "identifier": "NM001G14",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Samia Van Hattum, LCSW
• Katia Van Horn, LMT
• Scott Van Note, LMHC
• John Robert Vanderhee, PA-C, MPAS
• Laurie Danielle Vanderjagt
• Saskia Vanderploeg, CASE MANAGER
• Charles Nmi Vandiver, R.PH., PH.C.
• Yvette Vandiver, OTR/L
• Blake Vanegeren
• Vanette M. Sanchez, LCSW LLC

• Anatomic Pathology & Clinical Pathology Physician in Santa Fe, NM
• Providers in Santa Fe, NM by specialty
• Anatomic Pathology & Clinical Pathology Physician in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2008; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.