Individual provider Active NPI

Lydia Grace Brandt

  • Advanced Practice Midwife
  • Santa Fe, NM
National Provider Identifier
1871356667
Registry record updated Feb 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
872 Issued in NM
Practice address
455 Saint Michaels Dr
Santa Fe, NM 87505-7601
Phone
(505) 913-3361
NPI assigned
Feb 5, 2024
Last updated
Feb 5, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Midwife 367A00000X 872 NM Primary

Addresses

Primary practice location

455 Saint Michaels Dr
Santa Fe, NM 87505-7601

Mailing address

6 Monte Enebro
Santa Fe, NM 87506-2784
Phone (307) 380-6276

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240530003285 NM Practitioner - Certified Nurse Midwife (CNM) 8527400902 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife

State licenses

LicenseStateTypeSpecialty
872NMMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
St. Vincent Hospital CurrentSince Apr 17, 2024 Accepting new patients
St. Vincent Hospital CurrentSince Apr 17, 2024 Accepting new patients
St Vincent Hospital Current Accepting new patients

Locations

1622 Galisteo St
Ste 100
Santa Fe, NM 87505
Phone (505) 913-3380

1622 Galisteo St
Ste 200
Santa Fe, NM 87505
Phone (214) 500-0174

455 Saint Michaels Dr
Santa Fe, NM 87505
Phone (505) 913-3361

455 Saint Michaels Dr
Ste 300
Santa Fe, NM 87505

465 Saint Michaels Dr
Ste 200
Santa Fe, NM 87505
Phone (505) 995-4901

Interoperability endpoints

  • Direct secure messaging: lbrandt316855@christushealth.direct-ci.net

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1707091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707091200000",
    "number": "1871356667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 MONTE ENEBRO",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875062784",
            "telephone_number": "307-380-6276"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "455 SAINT MICHAELS DR",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875057601",
            "telephone_number": "505-913-3361"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRANDT",
        "first_name": "LYDIA",
        "middle_name": "GRACE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-05",
        "last_updated": "2024-02-05",
        "certification_date": "2024-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "NM",
            "license": "872",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Fe, NM

Sources for this page

Verify at the official NPI Registry.