Active NPI
Edward M Siegel, PHD
- Psychologist
- Santa Fe, NM
National Provider Identifier
1811005747
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 188
- Practice address
- 301 Johnson Street
Santa Fe, NM 87501-1828 - Phone
- (505) 983-3757
- Fax
- (505) 982-3300
- NPI assigned
- Aug 29, 2006
- Last updated
- Oct 6, 2011
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | 188 | NM | Primary |
Addresses
Primary practice location
301 Johnson Street
Santa Fe, NM 87501-1828
Mailing address
301 Johnson Street
Santa Fe, NM 87501-1828
Phone (505) 983-3757
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| N879 | Other | BCBS | |
| 201009233 | Other | PRESBYTERIAN HEALTH PLAN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156809600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1317859200000",
"number": "1811005747",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "301 JOHNSON STREET",
"city": "SANTA FE",
"state": "NM",
"postal_code": "875011828",
"telephone_number": "505-983-3757",
"fax_number": "505-982-3300"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "301 JOHNSON STREET",
"city": "SANTA FE",
"state": "NM",
"postal_code": "875011828",
"telephone_number": "505-983-3757",
"fax_number": "505-982-3300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SIEGEL",
"first_name": "EDWARD",
"middle_name": "M",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-29",
"last_updated": "2011-10-06",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NM",
"license": "188",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "N879",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PRESBYTERIAN HEALTH PLAN",
"identifier": "201009233",
"state": null
}
],
"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 Oct 6, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.