Leticia Moedano, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD2022-1484 Issued in NM

Practice address

2025 Galisteo St
Santa Fe, NM 87505-2101

Phone

(602) 655-6300

NPI assigned

May 7, 2018

Last updated

Jan 13, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ, NM2 enrollments

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 2

Specialty

Family Practice

Education

University of Arizona College of Medicine, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

St Vincent HospitalGroup PAC ID 6608775135, 335 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Centerwell Home Health Home health agency, Albuquerque, NM, CCN 327070
• Christus St Vincent Regional Medical Center Hospital, Santa Fe, NM, CCN 320002

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lmoedano190771@direct.valleywisehealth.org
• Direct secure messaging: lmoedano299489@christushealth.direct-ci.net

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.

• St Vincent Hospital

  dba CHRISTUS St. Vincent Pediatrics

  • Pediatrics Physician
  • Santa Fe, NM
  • NPI 1063367803
  Medicare reassignment Care Compare group
• District Medical Group, Inc

  • Anatomic Pathology & Clinical Pathology Physician
  • Phoenix, AZ
  • NPI 1336472448
  Medicare reassignment NPD
• St Vincent Hospital

  dba CHRISTUS St. Vincent Regional Medical Center

  • General Acute Care Hospital
  • Santa Fe, NM
  • NPI 1578587150
  NPD
• St. Vincent Hospital

  dba CHRISTUS St. Vincent Adult and Family Care

  • Family Medicine Physician
  • Santa Fe, NM
  • NPI 1245438647
  NPD
• St. Vincent Hospital

  dba CHRISTUS St. Vincent Family Medicine Center

  • General Practice Physician
  • Santa Fe, NM
  • NPI 1457618852

  Family Medicine

  NPD
• District Medical Group, Inc

  • Emergency Medicine Physician
  • Phoenix, AZ
  • NPI 1144624339
  NPD
• District Medical Group, Inc

  • Pulmonary Disease Physician
  • Phoenix, AZ
  • NPI 1700119815
  NPD
• District Medical Group, Inc

  • Internal Medicine Physician
  • Phoenix, AZ
  • NPI 1295968162

  Family Medicine

  NPD (past)

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

• Centerwell Certified Healthcare Corp.

  dba CenterWell Home Health

  • Home Health Agency
  • Albuquerque, NM
  • NPI 1295761997
  Care Compare affiliation
• St Vincent Hospital

  dba CHRISTUS St. Vincent Regional Medical Center

  • General Acute Care Hospital
  • Santa Fe, NM
  • NPI 1578587150
  Care Compare affiliation

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

{
    "created_epoch": "1525651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673568000000",
    "number": "1831688647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2177 S 29TH AVE",
            "city": "YUMA",
            "state": "AZ",
            "postal_code": "853646042",
            "telephone_number": "928-580-9811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2025 GALISTEO ST",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875052101",
            "telephone_number": "602-655-6300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOEDANO",
        "first_name": "LETICIA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-05-07",
        "last_updated": "2023-01-13",
        "certification_date": "2023-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "63273",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NM",
            "license": "MD2022-1484",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Arianna Mladosich
• Mobile Medicine
• Natalie Moctezuma, M.S. CFY-SLP
• Marcel Millado Modelo, PTA
• Modern Mystic, LLC
• Kevin Moeller, LMSW
• Alexandrea N Moffett, MS.CCC-SLP
• Patricia Mogan
• Carly Mohler, DOM
• Molecular Health Care USA LLC (Molecular Health Care)

• Family Medicine Physician in Santa Fe, NM
• Providers in Santa Fe, NM by specialty
• Family Medicine Physician in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2023; 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.