Individual provider Active NPI

Michael Reginald McKinney, M.D.

  • Family Medicine Physician
  • Santa Fe, NM
National Provider Identifier
1811330434
Registry record updated Mar 13, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD2015-0667 Issued in NM
Practice address
435 Saint Michaels Dr
Santa Fe, NM 87505-7672
Phone
(505) 913-3450
Fax
(505) 913-3451
NPI assigned
Apr 12, 2013
Last updated
Mar 13, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NM
Family Medicine Physician 207Q00000X MD2015-0667 NM Primary

Addresses

Primary practice location

435 Saint Michaels Dr
Santa Fe, NM 87505-7672

Mailing address

435 Saint Michaels Dr
Santa Fe, NM 87505-7672
Phone (505) 913-3450

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20160802000673 NM Practitioner - Family Practice 2668605940 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of New Mexico School of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Vincent HospitalGroup PAC ID 6608775135, 335 clinicians

Practice addresses (Care Compare)

5501 Herrera Dr
B
Santa Fe, NM 87507-2684
Phone (505) 913-4180

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD2015-0667NMMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St. Vincent Hospital Family Medicine CurrentSince Jul 1, 2016 Accepting new patients
St. Vincent Hospital Family Medicine CurrentSince Jul 1, 2016 Accepting new patients
St Vincent Hospital Current Accepting new patients
Santa Fe Pain & Spine Specialists PC Past Accepting new patients

Locations

1631 Hospital Dr
Ste 100
Santa Fe, NM 87505
Phone (505) 955-8420

435 Saint Michaels Dr
Ste B104
Santa Fe, NM 87505
Phone (505) 820-9945

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

5501 Herrera Dr
#B
Santa Fe, NM 87507
Phone (505) 913-4180

Interoperability endpoints

  • Direct secure messaging: mmckinney164896@christushealth.direct-ci.net

Organizations & group practices 5

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.

Hospital & facility affiliations 1

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": "1365724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489363200000",
    "number": "1811330434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "435 SAINT MICHAELS DR",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875057672",
            "telephone_number": "505-913-3450",
            "fax_number": "505-913-3451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "435 SAINT MICHAELS DR",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875057672",
            "telephone_number": "505-913-3450",
            "fax_number": "505-913-3451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKINNEY",
        "first_name": "MICHAEL",
        "middle_name": "REGINALD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-04-12",
        "last_updated": "2017-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NM",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NM",
            "license": "MD2015-0667",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Fe, NM

Sources for this page

Verify at the official NPI Registry.