NPIMap

Organization Active NPI

Santa Fe Mountain Center Inc

Doing business as The Mountain Center

  • Community/Behavioral Health Agency
  • Tesuque, NM
National Provider Identifier
1861695769
Registry record updated Jul 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
SANTA FE MOUNTAIN CENTER INC
Doing business as
The Mountain Center
Practice address
1524 Bishops Lodge Road
Tesuque, NM 87574-0449
Phone
(505) 983-6158
Fax
(505) 983-0460
NPI assigned
Jun 7, 2007
Last updated
Jul 1, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2020

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

Authorized official

Name
Juan Dixon
Title
Executive Director
Phone
(505) 490-3549

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

1524 Bishops Lodge Road
Tesuque, NM 87574-0449

Mailing address

PO Box 449
Tesuque, NM 87574-0449
Phone (505) 983-6158

Other identifiers 1

IdentifierTypeStateIssuer
NM600490OtherNMVALUEOPTIONSNM PROVIDER #

Other names 1

  • The Mountain Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200819000307 NM Part B Supplier - Clinic/Group Practice 6406272608 Receives reassigned benefits from 6 practitioners
Practice locations: Espanola, NM; Santa Fe, NM

National Provider Directory

National Provider Directory

Locations

1000 N Paseo de Onate
Espanola, NM 87532
Phone (505) 231-0652

4001 Office Court Dr
Ste 906
Santa Fe, NM 87507
Phone (505) 310-5654

Practitioners & affiliated clinicians

Practitioners 46

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 46

NPI Registry JSON

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

{
    "created_epoch": "1181174400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1593561600000",
    "number": "1861695769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 449",
            "city": "TESUQUE",
            "state": "NM",
            "postal_code": "875740449",
            "telephone_number": "505-983-6158",
            "fax_number": "505-983-0460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1524 BISHOPS LODGE ROAD",
            "city": "TESUQUE",
            "state": "NM",
            "postal_code": "875740449",
            "telephone_number": "505-983-6158",
            "fax_number": "505-983-0460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SANTA FE MOUNTAIN CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-07",
        "last_updated": "2020-07-01",
        "certification_date": "2020-07-01",
        "status": "A",
        "authorized_official_last_name": "DIXON",
        "authorized_official_first_name": "JUAN",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "505-490-3549"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUEOPTIONSNM PROVIDER #",
            "identifier": "NM600490",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Mountain Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tesuque, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2020; 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.