Individual provider Active NPI

Teresa Diane Pratt, M.D.

  • Adult Medicine Physician
  • Santa Fe, NM
National Provider Identifier
1912040288
Registry record updated Apr 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Medicine PhysicianTaxonomy code 207QA0505X
License
29045 Issued in CO
Practice address
1700 Cerrillos Rd
Santa Fe, NM 87505-3554
Phone
(505) 988-9821
Fax
(505) 983-6243
NPI assigned
Feb 15, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 23, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD24281 OR
Adult Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207QA0505X 29045 CO Primary

Addresses

Primary practice location

1700 Cerrillos Rd
Santa Fe, NM 87505-3554

Mailing address

1700 Cerrillos Rd
Santa Fe, NM 87505-3026
Phone (505) 946-9361

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080103000721 TX Practitioner - Family Practice 7315931631 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
George Washington University School of Medicine, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Santa Fe Indian HospitalGroup PAC ID 7719883289, 19 clinicians

Practice addresses (Care Compare)

1700 Cerrillos Rd
Santa Fe, NM 87505-3026
Phone (505) 946-9206

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
29045COMDAdult Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Santa Fe Indian Hospital Single Specialty CurrentSince Apr 1, 2007 Accepting new patients
Santo Domingo Health Clinic Single Specialty Past Accepting new patients

Locations

400 State Road 30
Espanola, NM 87532
Phone (505) 753-8393

1700 Cerrillos Rd
Santa Fe, NM 87505
Phone (505) 946-9206

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.

NPI Registry JSON

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

{
    "created_epoch": "1171497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745366400000",
    "number": "1912040288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 CERRILLOS RD",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875053026",
            "telephone_number": "505-946-9361",
            "fax_number": "505-946-9413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 CERRILLOS RD",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875053554",
            "telephone_number": "505-988-9821",
            "fax_number": "505-983-6243"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRATT",
        "first_name": "TERESA",
        "middle_name": "DIANE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-15",
        "last_updated": "2025-04-23",
        "certification_date": "2025-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "MD24281",
            "primary": false
        },
        {
            "code": "207QA0505X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine, Adult Medicine",
            "state": "CO",
            "license": "29045",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Fe, NM

Sources for this page

Verify at the official NPI Registry.