NPIMap

Organization Active NPI

St. Vincent Hospital

  • Neurology Physician
  • Santa Fe, NM
National Provider Identifier
1831493584
Registry record updated Feb 4, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
14-00123761 Issued in NM
Legal business name
ST. VINCENT HOSPITAL
Practice address
440 Saint Michaels Dr
Suite 250
Santa Fe, NM 87505-7602
Phone
(505) 913-3056
Fax
(505) 989-6021
NPI assigned
Jan 10, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2014

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

Authorized official

Name
Bruce Tassin
Title
President/Ceo
Phone
(505) 820-5202

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2084N0400X 14-00123761 NM Primary

Addresses

Primary practice location

440 Saint Michaels Dr
Suite 250
Santa Fe, NM 87505-7602

Mailing address

440 Saint Michaels Dr
Suite 250
Santa Fe, NM 87505-7602
Phone (505) 913-3056

Other identifiers 1

IdentifierTypeStateIssuer
95895314MedicaidNM

Other names 1

  • CHRISTUS St. Vincent Behavioral Health Specialists Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM, FL, CA, TX, NY, TN, NC, CO8 enrollments

Enrollment records 8

Enrollment IDStateProvider typePAC IDDetails
O20040105000372 NM Part B Supplier - Clinic/Group Practice 6608775135 Receives reassigned benefits from 425 practitioners
This NPI is an additional NPI on the enrollment
Practice locations: Santa Fe, NM; Los Alamos, NM; Albuquerque, NM; Espanola, NM; Farmington, NM; Las Vegas, NM
O20200124000988 FL Part B Supplier - Clinic/Group Practice 6608775135 Receives reassigned benefits from 8 practitioners
2 other NPIs on this enrollment
Practice locations: Tallahassee, FL; Boca Raton, FL; Palmetto Bay, FL; Orlando, FL; Cutler Bay, FL; Coconut Grove, FL; Babcock Ranch, FL; Land O Lakes, FL
O20210409001788 CA Part B Supplier - Clinic/Group Practice 6608775135 Receives reassigned benefits from 2 practitioners
3 other NPIs on this enrollment
Practice locations: Los Angeles, CA; San Jose, CA
O20240828002468 TX Part B Supplier - Clinic/Group Practice 6608775135 Receives reassigned benefits from 5 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Dallas, TX; Whitney, TX; Spring, TX; Rowlett, TX; Prosper, TX; Mansfield, TX; Irving, TX; El Paso, TX…
O20240923000183 NY Part B Supplier - Clinic/Group Practice 6608775135 Receives reassigned benefits from 2 practitioners
Practice locations: Armonk, NY; Buffalo, NY
O20241031003419 TN Part B Supplier - Clinic/Group Practice 6608775135 Receives reassigned benefits from 1 practitioner
Practice locations: Knoxville, TN
O20241227001835 NC Part B Supplier - Clinic/Group Practice 6608775135 Receives reassigned benefits from 2 practitioners
Practice locations: Crouse, NC; Reidsville, NC
O20241231001829 CO Part B Supplier - Clinic/Group Practice 6608775135 Receives reassigned benefits from 1 practitioner
Practice locations: Denver, CO

Other NPIs with the same Medicare PAC ID 8

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 5

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 37

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 37

NPI Registry JSON

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

{
    "created_epoch": "1294617600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1391472000000",
    "number": "1831493584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "440 SAINT MICHAELS DR",
            "address_2": "SUITE 250",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875057602",
            "telephone_number": "505-913-3056",
            "fax_number": "505-989-6021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "440 SAINT MICHAELS DR",
            "address_2": "SUITE 250",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875057602",
            "telephone_number": "505-913-3056",
            "fax_number": "505-989-6021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. VINCENT HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-10",
        "last_updated": "2014-02-04",
        "status": "A",
        "authorized_official_last_name": "TASSIN",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "505-820-5202"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NM",
            "license": "14-00123761",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "95895314",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CHRISTUS St. Vincent Behavioral Health Specialists",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Feb 4, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.