NPIMap

Organization Active NPI

Presbyterian Medical Services

Doing business as Pecos Valley Medical Center

  • Federally Qualified Health Center (FQHC)
  • Pecos, NM
National Provider Identifier
1922656404
Registry record updated Jun 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
PRESBYTERIAN MEDICAL SERVICES
Doing business as
Pecos Valley Medical Center
Practice address
199 Highway 50
BLDG a
Pecos, NM 87552
Phone
(505) 757-6482
Fax
(505) 443-8304
NPI assigned
Aug 28, 2019
Last updated
Jun 2, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2026

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

Authorized official

Name
Doug Smith
Title
Executive VP
Phone
(505) 982-5565

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary
Community/Retail Pharmacy 3336C0003X

Addresses

Primary practice location

199 Highway 50
BLDG a
Pecos, NM 87552

Mailing address

PO Box 2267
Santa Fe, NM 87504-2267
Phone (505) 982-5565

Other names 1

  • Pecos Valley Medical Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20031103000414 NM Part B Supplier - Clinic/Group Practice 2062324684 Receives reassigned benefits from 340 practitioners
9 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Santa Fe, NM; Socorro, NM; Rio Rancho, NM; Pecos, NM; Espanola, NM; Deming, NM; Carlsbad, NM; Albuquerque, NM…
O20191030000276 NM Part A Provider - Federally Qualified Health Center (FQHC) 2062324684 Practice locations: Pecos, NM

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1922656404. Details of each certification follow.

Federally qualified health center certification: CCN 321967

Legal name
PRESBYTERIAN MEDICAL SERVICES
Doing business as
PECOS VALLEY MEDICAL CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Oct 30, 2019
Last certification
Oct 30, 2019
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Aug 1, 1969 in NM
Enrollment address
199 Highway 50
Pecos, NM 87552

Other NPIs on the same Medicare enrollment 9

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
32D0058219PMS - Pecos Valley Medical Center199 Highway 50, Pecos, NM 87552Certificate of waiverSep 30, 2027

National Provider Directory

National Provider Directory
Tax ID family
PMS Questa Health Cente70 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 19

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 19

Locations

1501 10th St
Alamogordo, NM 88310
Phone (505) 443-8133

Ownership & related parties

All disclosed owners & managing parties 12

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Roberta Lee Individual Corporate DirectorBoard Member Oct 11, 2022
Steven C Hansen Individual Corporate OfficerPresident Nov 1, 2007
Mike Antiporda Individual Corporate DirectorBoard Member Jun 3, 2022
Scott Michlin Individual Corporate DirectorBoard Member Aug 22, 2011
Doug Smith Individual Corporate OfficerExecutive Vice President & Treas Aug 22, 2011
Marlene Waukazoo Individual Corporate DirectorBoard Member Nov 1, 2012
Bryan Romkey Individual Corporate DirectorBoard Member Feb 5, 2015
Frank McCasland Individual Corporate DirectorBoard Member Aug 22, 2011
Melissa Sharpe Individual Corporate DirectorBoard Member Feb 5, 2015
Susan K Smith Individual Corporate DirectorBoard Member Aug 22, 2011
Cynthia Rael-Vigil Individual Corporate DirectorBoard Member Aug 22, 2011
Kent E Mosbrucker Individual W-2 Managing EmployeeVice President of Finance Aug 31, 2018

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Santa Fe Family Health CenterSante Fe, NM, CCN 321950 Federally qualified health center 5% Or Greater Direct Ownership Interest Oct 1, 2012

Practitioners & affiliated clinicians

Practitioners 30

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 30

NPI Registry JSON

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

{
    "created_epoch": "1566950400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1780358400000",
    "number": "1922656404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2267",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875042267",
            "telephone_number": "505-982-5565",
            "fax_number": "505-992-4990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "199 HIGHWAY 50",
            "address_2": "BLDG A",
            "city": "PECOS",
            "state": "NM",
            "postal_code": "87552",
            "telephone_number": "505-757-6482",
            "fax_number": "505-443-8304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRESBYTERIAN MEDICAL SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-08-28",
        "last_updated": "2026-06-02",
        "certification_date": "2026-06-02",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "DOUG",
        "authorized_official_title_or_position": "EXECUTIVE VP",
        "authorized_official_telephone_number": "505-982-5565"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pecos Valley Medical Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Pecos Valley Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pecos, NM

Sources for this page

Verify at the official NPI Registry.