PRESBYTERIAN HEALTHCARE SERVICES (NPI# 1154307593) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154307593 |
| Entity Type | Organization |
| Organization Name | PRESBYTERIAN HEALTHCARE SERVICES |
| Other Organization Name | ESPANOLA HOSPITAL |
| Practice Address |
1010 Spruce St Espanola NM 87532-3456 |
| Mailing Address |
Po Box 26666 Provider Enrollment Albuquerque NM 87125-6666 |
| Practice Telephone | 5057537111 |
| Practice Fax Number | 5057534438 |
| Mailing Telephone | 5059235356 |
| Mailing Fax Number | 5059235354 |
| Enumeration Date | 2005-12-19 |
| Last Update Date | 2010-03-30 |
| Authorized Official Name | MR. ROBERT GARCIA (VP REGIONAL OPERATIONS) |
| Authorized Official Telephone | 5059235339 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207P00000X | Emergency Medicine | Allopathic & Osteopathic Physicians | ||
| N | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians | ||
| N | 3416L0300X |
Ambulance Specialization: Land Transport |
6090 | NM | Transportation Services |
| Y | 282NR1301X |
General Acute Care Hospital Specialization: Rural |
6090 | NM | Hospitals |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NM | PART B | 2252104 | 01 |
| NM | 00265 | 05 |
| Other Name | Type Code |
|---|---|
| Espanola Hospital | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730684853 | Presbyterian Healthcare Services | General Acute Care Hospital | 4801 Beckner Road, Santa Fe, NM 87507 | 2018-03-29 |
| 1942615570 | Presbyterian Healthcare Services | Pharmacy | 2401 W. 21st St, Clovis, NM 88101 | 2014-06-23 |
| 1215913470 | Presbyterian Healthcare Services | Emergency Medicine | 1100 Central Se, Albuquerque, NM 87106-4930 | 2005-12-20 |
| 1508842758 | Presbyterian Healthcare Services | Emergency Medicine | 615 Prospect Ave, Springer, NM 87747 | 2005-12-20 |
| 1053397497 | Presbyterian Healthcare Services | Medicare Defined Swing Bed Unit | 2200 W 21st St, Clovis, NM 88101-2011 | 2005-12-19 |
| 1336125764 | Presbyterian Healthcare Services | Emergency Medicine | 1202 Highway 60 Bldg E, Socorro, NM 87801-3914 | 2005-12-19 |
| 1972589307 | Presbyterian Healthcare Services | Emergency Medicine | 1202 Highway 60 Building E, Socorro, NM 87801 | 2005-12-19 |
| 1295710176 | Presbyterian Healthcare Services | Emergency Medicine | 2217 Dillon, Clovis, NM 88101-9454 | 2005-12-13 |
| 1235114125 | Presbyterian Healthcare Services | Emergency Medicine | 710 Avenue E, Carrizozo, NM 88301-0008 | 2005-12-13 |
| 1750366639 | Presbyterian Healthcare Services | Emergency Medicine | 2217 Dillon Rd, Clovis, NM 88101-9454 | 2005-12-13 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | PRESBYTERIAN HEALTHCARE SERVICES | 9521 San Mateo Blvd Ne, Albuquerque, NM 87113-2237 |
| Colorado Business Entities | PRESBYTERIAN HEALTHCARE SERVICES | 5901 Harper N E, Albuquerque, NM 87109 |
| Street Address |
1010 SPRUCE ST |
| City | ESPANOLA |
| State | NM |
| Zip Code | 87532-3456 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477552172 | Peter Holtz | Nurse Anesthetist, Certified Registered | 1010 Spruce St, Espanola, NM 87532-3456 | 2005-07-15 |
| 1861004715 | Folsom Anesthesia LLC | Nurse Anesthetist, Certified Registered | 1010 Spruce St, Espanola, NM 87532-2746 | 2020-08-21 |
| 1417514712 | Kathy Lynn Wirz | Nurse Practitioner | 1010 Spruce St, Espanola, NM 87532-2724 | 2019-05-22 |
| 1790259455 | Elizabeth Nunez | Nurse Practitioner | 1010 Spruce St, Espanola, NM 87532-2724 | 2019-01-16 |
| 1477062370 | Vanessa Monique Lucero | Pharmacist | 1010 Spruce St, Espanola, NM 87532-2724 | 2017-09-22 |
| 1972023810 | Amelia Brooks Kreienkamp | Pediatrics | 1010 Spruce St, Espanola, NM 87532-2724 | 2017-06-21 |
| 1568992220 | Gary Kanner | Emergency Medicine | 1010 Spruce St, Espanola, NM 87532-2724 | 2017-06-15 |
| 1033640263 | Kimberly Allen | Nurse Practitioner | 1010 Spruce St, Espanola, NM 87532-2724 | 2017-03-21 |
| 1336670405 | Julian R. Benavidez | Pediatrics | 1010 Spruce St, Espanola, NM 87532-2724 | 2017-03-21 |
| 1912303900 | Leora Ellen Shein | Registered Nurse | 1010 Spruce St, Presbyterian Espanola Hospital, Espanola, NM 87532-2724 | 2014-11-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720690423 | David A. Bustos | Non-emergency Medical Transport (VAN) | 1736 Calle Culebra, Espanola, NM 87532 | 2020-08-24 |
| 1407484942 | Rosita Lorreyna Sanchez | Behavior Technician | 3 Calle Baca, Espanola, NM 87532 | 2020-03-30 |
| 1437615564 | Troy Campbell | Counselor | 19525 Tomas Ln, Espanola, NM 87532 | 2019-02-13 |
| 1174099428 | Marisa Anaya | Registered Nurse | 420 N Coronado Ave, Espanola, NM 87532 | 2018-10-15 |
| 1780169938 | Celina Velasquez | Specialist/Technologist | 8 Camino Velasquez Ln., Espanola, NM 87532 | 2018-10-03 |
| 1356864656 | Jacqueline Andrea Zamora Alvarado | Behavior Technician | 3 Boneyard Rd, Espanola, NM 87532 | 2017-07-19 |
| 1619423902 | Mariah Maureen Martinez | Specialist/Technologist | 1421 Montana Vista St, Espanola, NM 87532 | 2016-08-28 |
| 1851847180 | Shannon Vigil | Perfusionist | 829 Calle Juan Jose Vigil, Espanola, NM 87532 | 2016-08-28 |
| 1144684234 | Tanya P. Reyes | Family Medicine | El Centro Family Health, 2010 Industrial Park Rd., Espanola, NM 87532 | 2016-04-05 |
| 1780058768 | Kale Lee Dennis | Massage Therapist | 2 Old Orchard Ln, Espanola, NM 87532 | 2015-11-13 |
| Find all providers in zip 87532 | ||||
| Taxonomy Code | 282NR1301X |
| Grouping | Hospitals |
| Classification | General Acute Care Hospital |
| Specialization | Rural |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063882058 | Nor Lea General Hospital | General Acute Care Hospital | 1600 N Main Ave, Lovington, NM 88260-2830 | 2015-10-02 |
| 1285701623 | Phc-los Alamos Inc | General Acute Care Hospital | 3917 West Rd, Los Alamos, NM 87544-2275 | 2006-11-29 |
| 1891886065 | Mescalero Indian Hospital | General Acute Care Hospital | 318 Abalone Loop, Mescalero, NM 88340-0210 | 2006-09-27 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.