NPIMap

Organization Active NPI

Santa Fe Indian Hospital

  • Psychiatry Physician
  • Santa Fe, NM
National Provider Identifier
1992782650
Registry record updated Sep 13, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
89-288 Issued in NM
Legal business name
SANTA FE INDIAN HOSPITAL
Practice address
1700 Cerrillos Rd
Santa Fe, NM 87505-3554
Phone
(505) 946-9264
Fax
(505) 946-9556
NPI assigned
Dec 23, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2011

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

Authorized official

Name
Dr. Mary Hasbah Roessel, M.D.
Title
Psychiatrist
Phone
(505) 946-9264

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X 89-288 NM Primary

Addresses

Primary practice location

1700 Cerrillos Rd
Santa Fe, NM 87505-3554

Mailing address

1700 Cerrillos Rd
Santa Fe, NM 87505-3554
Phone (505) 946-9264

Other identifiers 1

IdentifierTypeStateIssuer
Q9691MedicaidNM

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1135296000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1315872000000",
    "number": "1992782650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 CERRILLOS RD",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875053554",
            "telephone_number": "505-946-9264",
            "fax_number": "505-946-9556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 CERRILLOS RD",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875053554",
            "telephone_number": "505-946-9264",
            "fax_number": "505-946-9556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SANTA FE INDIAN HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-23",
        "last_updated": "2011-09-13",
        "status": "A",
        "authorized_official_last_name": "ROESSEL",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "HASBAH",
        "authorized_official_title_or_position": "PSYCHIATRIST",
        "authorized_official_telephone_number": "505-946-9264",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NM",
            "license": "89-288",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q9691",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Sep 13, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.