Hidalgo Medical Services
Organization Active NPI Federally Qualified Health Center (FQHC) · Bayard, NM
NPI 1861432015 · NPPES record last updated Mar 4, 2016
Key facts
- NPI
- 1861432015
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Federally Qualified Health Center (FQHC) 261QF0400X
- License
- 3228 (NM)
- Legal business name
- HIDALGO MEDICAL SERVICES
- Practice address
- 805 Tom Foy Blvd
Bayard, NM 88023-9767 - Phone
- (575) 537-5068
- Fax
- (575) 542-2388
- NPI assigned
- Jun 7, 2006
- Organization subpart
- Yes
- Parent organization (as reported)
- HIDALGO MEDICAL SERVICES
Authorized official
- Name
- Daniel Otero
- Title
- Ceo
- Phone
- (575) 542-2322
Other NPIs on the same Medicare enrollment 12
Practitioners 4
-
Andrew George Lefave, LCSW
-
Darrick P. Nelson, M.D
-
Edla J Rucker, NP
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NM
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040303001246 | NM | Part B Supplier - Clinic/Group Practice | 4587572250 |
Receives reassigned benefits from 99 practitioners 12 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Silver City, NM; Santa Clara, NM; Lordsburg, NM; Mimbres, NM; Gila, NM; Bayard, NM; Animas, NM |
National Provider Directory
- Part of
- Hidalgo Medical Services
Locations
805 Tom Foy Blvd
Bayard, NM 88023
Phone (505) 537-0200
114 W 11th St
Silver City, NM 88061
Phone (575) 388-1511
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Federally Qualified Health Center (FQHC) | 261QF0400X | 3228 | NM | Yes |
Addresses
Primary practice location
805 Tom Foy Blvd
Bayard, NM 88023-9767
Mailing address
530 De Moss St
Lordsburg, NM 88045-2618
Phone (575) 542-2368
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 98652834 | Medicaid | NM |
Other names
- HMS-Bayard Community Health Center
Other providers in Bayard, NM
- Fort Bayard Medical Center
- Yvette Gonzales
- Angie O Guerra
- Rosemary L Gutierrez
- Hidalgo Medical Services
- Brad K Holmgren
- Antonio Gonzales Jacquez
- Clifton Ray Jones
- Luna de Cobre Therapy Center, LLC
- Brittany Rose Madrid
All providers in Bayard, NM · Federally Qualified Health Center (FQHC) in New Mexico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 4, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.