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Presbyterian Medical Services

Organization Active NPI Federally Qualified Health Center (FQHC) · Pecos, NM

NPI 1922656404 · NPPES record last updated Jun 2, 2026

Key facts

NPI
1922656404
Entity type
Organization (NPI type 2)
Primary specialty
Federally Qualified Health Center (FQHC) 261QF0400X
Legal business name
PRESBYTERIAN MEDICAL SERVICES
Practice address
199 Highway 50
BLDG a
Pecos, NM 87552
Phone
(505) 757-6482
Fax
(505) 443-8304
NPI assigned
Aug 28, 2019
Organization subpart
No

Authorized official

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

Other NPIs on the same Medicare enrollment 9

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

Corporate family (same tax ID) 19

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners 30

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 30

Laboratory certificates & supplier records

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

CLIA laboratory certificates

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

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in NM

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
Corporation · Non-profit
Incorporated
Aug 1, 1969 in NM
Enrollment address
199 Highway 50
Pecos, NM 87552

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 Director
Board Member		 Oct 11, 2022
Steven C Hansen
Individual 		Corporate Officer
President		 Nov 1, 2007
Mike Antiporda
Individual 		Corporate Director
Board Member		 Jun 3, 2022
Scott Michlin
Individual 		Corporate Director
Board Member		 Aug 22, 2011
Doug Smith
Individual 		Corporate Officer
Executive Vice President & Treas		 Aug 22, 2011
Marlene Waukazoo
Individual 		Corporate Director
Board Member		 Nov 1, 2012
Bryan Romkey
Individual 		Corporate Director
Board Member		 Feb 5, 2015
Frank McCasland
Individual 		Corporate Director
Board Member		 Aug 22, 2011
Melissa Sharpe
Individual 		Corporate Director
Board Member		 Feb 5, 2015
Susan K Smith
Individual 		Corporate Director
Board Member		 Aug 22, 2011
Cynthia Rael-Vigil
Individual 		Corporate Director
Board Member		 Aug 22, 2011
Kent E Mosbrucker
Individual 		W-2 Managing Employee
Vice 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 Center
Sante Fe, NM · CCN 321950		 Federally qualified health center 5% Or Greater Direct Ownership Interest Oct 1, 2012

Medicare enrollment records

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

National Provider Directory

Tax ID family
PMS Questa Health Cente (70 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Yes
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

  • Pecos Valley Medical Center Doing business as

Other providers in Pecos, NM

All providers in Pecos, NM · Federally Qualified Health Center (FQHC) in New Mexico

Sources for this page

Verify at the official NPI Registry.