Individual provider Active NPI

Elizabeth Heeder, MD

  • Family Medicine Physician
  • Santa Fe, NM
National Provider Identifier
1962082388
Registry record updated Aug 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD2024-0467 Issued in NM
Practice address
454 Saint Michaels Dr Ste 200
Santa Fe, NM 87505-7602
Phone
(505) 303-5000
Fax
(505) 303-5202
NPI assigned
Apr 9, 2021
Last updated
Aug 21, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2024

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 MD2024-0467 NM Primary

Addresses

Primary practice location

454 Saint Michaels Dr Ste 200
Santa Fe, NM 87505-7602

Mailing address

PO Box 26666
Albuquerque, NM 87125-6666

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: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240821001285 NM Practitioner - Family Practice 5193168821 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Wayne State University School of Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Presbyterian Healthcare ServicesGroup PAC ID 9234041708, 1,390 clinicians

Practice addresses (Care Compare)

2200 W 21St St
Clovis, NM 88101-2011
Phone (505) 769-7577

454 Saint Michaels Dr
Santa Fe, NM 87505-7602
Phone (505) 473-0390

PO Box
Albuquerque, NM 87125-6666

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD2024-0467NMMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Presbyterian Healthcare Services Family Medicine CurrentSince Oct 8, 2024 Accepting new patients
Presbyterian Healthcare Services CurrentSince Oct 8, 2024 Accepting new patients
Presbyterian Healthcare Services PastSince Aug 25, 2024 Accepting new patients

Locations

2200 W 21st St
Clovis, NM 88101
Phone (505) 769-7577

454 Saint Michaels Dr
Ste 200
Santa Fe, NM 87505
Phone (505) 303-5000

Interoperability endpoints

  • Direct secure messaging: eheeder256122@direct.phs.org

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 5

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": "1617926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724198400000",
    "number": "1962082388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 26666",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871256666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "454 SAINT MICHAELS DR STE 200",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875057602",
            "telephone_number": "505-303-5000",
            "fax_number": "505-303-5202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEEDER",
        "first_name": "ELIZABETH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-09",
        "last_updated": "2024-08-21",
        "certification_date": "2024-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NM",
            "license": "MD2024-0467",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Fe, NM

Sources for this page

Verify at the official NPI Registry.