Active NPI
Jill Wendy Holtz, PSY
- Clinical Psychologist
- Santa Fe, NM
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY1514
- Practice address
- 54 St. Michaels Dr. Ste 200
Santa Fe, NM 87505-7602 - Phone
- (505) 303-5000
- NPI assigned
- May 27, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 10091 | NE | |
| Clinical Psychologist | 103TC0700X | 1514 | NM | |
| Student in an Organized Health Care Education/Training Program | 390200000X | NM | ||
| Clinical Psychologist | 103TC0700X | PSY1514 | NM | Primary |
Addresses
Primary practice location
54 St. Michaels Dr. Ste 200
Santa Fe, NM 87505-7602
Mailing address
PO Box 26666
Provider Enrollment
Albuquerque, NM 87125-6666
Phone (505) 923-6770
Other practice location 1
1 University Of New Mexico
Albuquerque, NM 87131-0001
Phone (412) 303-7459
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
2200 W 21St St
Clovis, NM 88101-2011
Phone (505) 769-7577
3777 NM Hwy 528 NE
Rio Rancho, NM 87144-7650
Phone (505) 404-2590
8300 Constitution Ave NE
Albuquerque, NM 87110-7613
Hospital & facility affiliations
- Presbyterian Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 88.68 of 100
- Quality
- 82.35
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 76.6
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1514 | NM | MD | Dentist |
| 10091 | NE | MD | Psychiatric Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Presbyterian Healthcare Services | Current | Accepting new patients | |
| Presbyterian Healthcare Services | Current | Accepting new patients |
Locations
2200 W 21st St
Clovis, NM 88101
Phone (505) 769-7577
Interoperability endpoints
- jholtz213735@direct.phs.org
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Internal Medicine Physician
- Albuquerque, NM
- NPI 1104802354
-
- General Acute Care Hospital
- Albuquerque, NM
- NPI 1215913470
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Albuquerque, NM
- NPI 1215913470
-
- Psychiatric Hospital Unit
- Albuquerque, NM
- NPI 1598740482
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1432684800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1655078400000",
"number": "1902285646",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 26666",
"address_2": "PROVIDER ENROLLMENT",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871256666",
"telephone_number": "505-923-6770",
"fax_number": "505-923-5354"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "54 ST. MICHAELS DR. STE 200",
"city": "SANTA FE",
"state": "NM",
"postal_code": "875057602",
"telephone_number": "505-303-5000"
}
],
"practiceLocations": [
{
"address_1": "1 University Of New Mexico",
"address_purpose": "LOCATION",
"city": "Albuquerque",
"state": "NM",
"postal_code": "871310001",
"country_code": "US",
"telephone_number": "412-303-7459",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "HOLTZ",
"first_name": "JILL",
"middle_name": "WENDY",
"name_prefix": "Dr.",
"credential": "PSY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-05-27",
"last_updated": "2022-06-13",
"certification_date": "2022-06-13",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NE",
"license": "10091",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NM",
"license": "1514",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "NM",
"license": null,
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NM",
"license": "PSY1514",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Santa Fe, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2022; 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.