NPIMap

Individual provider Active NPI

Patrick Samora, MD

  • Family Medicine Physician
  • Santa Fe, NM
National Provider Identifier
1881682912
Registry record updated Jul 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD2007-0786 Issued in NM
Practice address
465 Saint Michaels Dr
Suite 101
Santa Fe, NM 87505-7670
Phone
(505) 995-2400
NPI assigned
Oct 12, 2005
Last updated
Jul 6, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD2007-0786 NM Primary

Addresses

Primary practice location

465 Saint Michaels Dr
Suite 101
Santa Fe, NM 87505-7670

Mailing address

1414 Luisa St
Santa Fe, NM 87505-4347
Phone (505) 930-5040

Other identifiers 5

IdentifierTypeStateIssuer
46682040OtherNEW MEXICO MEDICAID
P00082076OtherTRAVELERS MEDICARE
SA666518OtherCOANTHEM BCBS
59577754MedicaidCO
840706945159OtherCOROCKY MOUNTAIN HEALH PLAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080408000104 NM Practitioner - Family Practice 0143118471 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Texas Southwestern Medical School at Dallas, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Family Medicine Partners of Santa Fe, P.C.Group PAC ID 4587884531, 2 clinicians

Practice addresses (Care Compare)

1414 Luisa St
Santa Fe, NM 87505-4347
Phone (505) 930-5040

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions11

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Family Medicine Partners of Santa Fe, P.C. Family Medicine CurrentSince Oct 1, 2014 Accepting new patients
Valley-Wide Health Systems, Inc. Past Accepting new patients
Optumcare Endoscopy Center New Mexico, LLC Past Accepting new patients

Locations

1414 Luisa St
Santa Fe, NM 87505
Phone (505) 930-4050

Interoperability endpoints

  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.441.400453

Organizations & group practices 3

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.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1129075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593993600000",
    "number": "1881682912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1414 LUISA ST",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875054347",
            "telephone_number": "505-930-5040",
            "fax_number": "505-930-5041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "465 SAINT MICHAELS DR",
            "address_2": "SUITE 101",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875057670",
            "telephone_number": "505-995-2400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMORA",
        "first_name": "PATRICK",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-12",
        "last_updated": "2020-07-06",
        "certification_date": "2020-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NM",
            "license": "MD2007-0786",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEW MEXICO MEDICAID",
            "identifier": "46682040",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRAVELERS MEDICARE",
            "identifier": "P00082076",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "SA666518",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "59577754",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ROCKY MOUNTAIN HEALH PLAN",
            "identifier": "840706945159",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Fe, NM

Sources for this page

Verify at the official NPI Registry.