NPIMap

Organization Active NPI

St. Vincent Hospital

  • Dermatology Physician
  • Santa Fe, NM
National Provider Identifier
1982104709
Registry record updated Jun 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
ST. VINCENT HOSPITAL
Practice address
490 W Zia Rd Ste 200
Santa Fe, NM 87505-6996
Phone
(505) 913-3380
Fax
(505) 913-3389
NPI assigned
Feb 19, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2026

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

Authorized official

Name
Lillian Montoya
Title
Ceo
Phone
(505) 913-5201

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207N00000X Primary

Addresses

Primary practice location

490 W Zia Rd Ste 200
Santa Fe, NM 87505-6996

Mailing address

455 Saint Michaels Dr
Santa Fe, NM 87505-7601
Phone (505) 913-3380

Other identifiers 2

IdentifierTypeStateIssuer
79680364MedicaidNM
3635OtherCSV DEPT CODE

Other names 1

  • CHRISTUS St. Vincent Dermatology Specialists Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040105000372 NM Part B Supplier - Clinic/Group Practice 6608775135 Receives reassigned benefits from 425 practitioners
This NPI is an additional NPI on the enrollment
Practice locations: Santa Fe, NM; Los Alamos, NM; Albuquerque, NM; Espanola, NM; Farmington, NM; Las Vegas, NM

National Provider Directory

National Provider Directory
Tax ID family
St Vincent Hospital28 organizations share this tax ID, including this one

Other organizations with this tax ID 27

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

View all 27

Locations

490 W Zia Rd
Ste 200
Santa Fe, NM 87505
Phone (505) 913-3101

465 Saint Michaels Dr
Ste 220
Santa Fe, NM 87505
Phone (505) 913-3380

490 W Zia Rd
Ste 260A
Santa Fe, NM 87505

1622 Galisteo St
Ste 100
Santa Fe, NM 87505
Phone (505) 913-3380

Practitioners & affiliated clinicians

Practitioners 5

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

NPI Registry JSON

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

{
    "created_epoch": "1518998400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1781136000000",
    "number": "1982104709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "455 SAINT MICHAELS DR",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875057601",
            "telephone_number": "505-913-3380",
            "fax_number": "505-913-3389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "490 W ZIA RD STE 200",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875056996",
            "telephone_number": "505-913-3380",
            "fax_number": "505-913-3389"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. VINCENT HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-02-19",
        "last_updated": "2026-06-11",
        "certification_date": "2026-06-11",
        "status": "A",
        "authorized_official_last_name": "MONTOYA",
        "authorized_official_first_name": "LILLIAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "505-913-5201"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "79680364",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CSV DEPT CODE",
            "identifier": "3635",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CHRISTUS St. Vincent Dermatology Specialists",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 11, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.