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San Juan Regional Medical Center Inc

Organization Active NPI Psychiatry Physician · Farmington, NM

NPI 1992764112 · NPPES record last updated Jul 16, 2025

Key facts

NPI
1992764112
Entity type
Organization (NPI type 2)
Primary specialty
Psychiatry Physician 2084P0800X
Legal business name
SAN JUAN REGIONAL MEDICAL CENTER INC
Practice address
555 S Schwartz Ave
Farmington, NM 87401-5955
Phone
(505) 609-6680
Fax
(505) 325-1722
NPI assigned
Mar 17, 2006
Organization subpart
No

Authorized official

Name
Kim Byrd
Title
Administrative Director of Reimburs
Phone
(505) 609-2258

Other NPIs on the same Medicare enrollment 18

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

Corporate family (same tax ID) 12

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

Practitioners 22

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

Medicare participation

Medicare fee-for-service enrollment
Enrolled in NM

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20040218000865 NM Part B Supplier - Clinic/Group Practice 4587559505 Receives reassigned benefits from 396 practitioners
18 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Farmington, NM; Bloomfield, NM; Aztec, NM

National Provider Directory

Tax ID family
San Juan Region Med Ctr Inc (13 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician
Group: 193400000X SINGLE SPECIALTY GROUP		 2084P0800X Yes

Addresses

Primary practice location

555 S Schwartz Ave
Farmington, NM 87401-5955

Mailing address

PO Box 844088
Dallas, TX 75284-4088
Phone (505) 609-2258

Other names

  • SJRMC BEHAVIORAL HEALTH SERVICES Doing business as

Other providers in Farmington, NM

All providers in Farmington, NM · Psychiatry Physician in New Mexico

Sources for this page

Verify at the official NPI Registry.