Wendy Johnson, MD

Individual provider Active NPI Family Medicine Physician · Santa Fe, NM

NPI 1982648093 · NPPES record last updated Jul 27, 2023

Key facts

NPI
1982648093
Entity type
Individual (NPI type 1)
Primary specialty
Family Medicine Physician 207Q00000X
License
98-299 (NM)
Practice address
1035 Alto St
Santa Fe, NM 87501-2406
Phone
(505) 982-4599
Fax
(505) 982-8440
NPI assigned
Jun 16, 2006
Sex
Female
Sole proprietor
No

Organizations & group practices 21

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

Medicare Care Compare profile

Specialty
Family Practice
Education
Ohio State University College of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
El Centro Family Health (31 clinicians)

Practice addresses (Care Compare)

538 N Paseo de Onate
Espanola, NM 87532-2618

PO Box
Espanola, NM 87532

PO Box
Espanola, NM 87532-0158

Hospital & facility affiliations

  • Presbyterian Espanola Hospital Hospital · Espanola, NM · CCN 320011

Medicare participation

Medicare fee-for-service enrollment
Enrolled in NM
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20140329000004 NM Practitioner - Family Practice 6204740004 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
98-299NMMDFamily Medicine Physician
35074913OHMDFamily Medicine Physician
MD00047755WAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
El Centro Family Health Current
since Nov 27, 2023
Accepting new patients
El Centro Family Health Current
since Nov 27, 2023
Accepting new patients
Taos Health Systems, Inc., Holy Cross Hospital Past Accepting new patients
El Centro Family Health Past Accepting new patients
City of Cleveland Dept. of Public Health Past
since Dec 31, 2003
Accepting new patients

Locations

538 N Paseo de Onate
Espanola, NM 87532
Phone (505) 753-7218

2010 Industrial Park Rd
Espanola, NM 87532
Phone (505) 753-3143

111 N Railroad Ave
Espanola, NM 87532
Phone (505) 753-7218

1235 8th St
Las Vegas, NM 87701
Phone (505) 425-6751

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: wendy.johnson@20337662754820.direct.elationemr.com

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD00047755 WA
Family Medicine Physician 207Q00000X 35074913 OH
Family Medicine Physician 207Q00000X 98-299 NM Yes

Addresses

Primary practice location

1035 Alto St
Santa Fe, NM 87501-2406

Mailing address

1035 Alto St
Santa Fe, NM 87501-2406
Phone (505) 982-4599

Other identifiers

IdentifierTypeStateIssuer
2072073MedicaidOH

Other providers in Santa Fe, NM

All providers in Santa Fe, NM · Family Medicine Physician in New Mexico

Sources for this page

Verify at the official NPI Registry.