MOLINA MEDICAL GROUP OF NEW MEXICO, PC


Address: 1714 Saint Michaels Dr # 1, Santa Fe, NM 87505-7617
Phone: 5054904042

MOLINA MEDICAL GROUP OF NEW MEXICO, PC (NPI# 1194150318) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1194150318
Entity Type Organization
Organization Name MOLINA MEDICAL GROUP OF NEW MEXICO, PC
Practice Address 1714 Saint Michaels Dr # 1
Santa Fe
NM 87505-7617
Mailing Address 200 Oceangate
Suite 100
Long Beach
CA 90802-4317
Practice Telephone 5054904042
Practice Fax Number 8778463680
Mailing Telephone 5054904042
Mailing Fax Number 5624996171
Enumeration Date 2013-09-06
Last Update Date 2014-05-27
Authorized Official Name GLORIA CALDERON (VP, CLINIC OPERATIONS)
Authorized Official Telephone 5624996191
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 208000000X Pediatrics NM Allopathic & Osteopathic Physicians
N 363L00000X Nurse Practitioner NM Physician Assistants & Advanced Practice Nursing Providers
N 363A00000X Physician Assistant NM Physician Assistants & Advanced Practice Nursing Providers
N 207R00000X Internal Medicine NM Allopathic & Osteopathic Physicians
N 104100000X Social Worker NM Behavioral Health & Social Service Providers
Y 207Q00000X Family Medicine NM Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
NM 72035005-EFF.1/21/14 05

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1033547146 Molina Medical Group of New Mexico, PC Pediatrics 200 Oceangate Ste 100, Long Beach, CA 90802-4317 2013-10-29
1366877581 Molina Medical Group of New Mexico, PC Physician Assistant 7317 Central Ave Ne, Albuquerque, NM 87108-2015 2013-09-06

Office Location

Street Address 1714 SAINT MICHAELS DR # 1
City SANTA FE
State NM
Zip Code 87505-7617

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1154939031 Enchanted Sky Hospice,llc Hospice Care, Community Based 1692b Hospital Drive, Vigil Office Building, Suite 201a, Santa Fe, NM 87505 2020-07-16
1700409968 Caa Consulting, LLC Clinic/Center 1448 S St. Francis Drive, Santa Fe, NM 87505 2020-05-22
1104447093 Dana Marie Tsyconyea Simmons Counselor 1640 Calle Medico, Suite E, Santa Fe, NM 87505 2020-05-01
1114574217 Kumara Hampton Therapy, LLC Counselor 11 Calle Medico Suite 4, Santa Fe, NM 87505 2019-08-22
1245886977 Caroline Ward Technician 513 Velarde St 513 Velarde St, Santa Fe, NM 87505 2019-08-19
1205490752 Alyson Yacono Physical Therapist 104 Old Las Vegas Highway, Santa Fe, NM 87505 2019-04-30
1366919649 Allyson Matthews Speech-Language Pathologist Santa Fe Public Schools Special Education Department, 1300 Camino Sierra Vista, Santa Fe, NM 87505 2018-10-25
1093280281 Diamond Care Santa Fe LLC Skilled Nursing Facility 635 Harkle Road, Santa Fe, NM 87505 2018-10-04
1972087054 Changing Woman Initiative Advanced Practice Midwife 460 Saint Michaels Drive, Suite 804, Santa Fe, NM 87505 2018-09-24
1154812782 Heart Wing, LLC Social Worker 2724 Alamosa Drive, Santa Fe, NM 87505 2018-05-18
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Taxonomy Information

Taxonomy Code 207Q00000X
Grouping Allopathic & Osteopathic Physicians
Classification Family Medicine

Taxonomy Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition]
- Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences.
- Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1053947408 Optimal Wellness Journey Family Medicine 3231 Caminito San Lucas, Santa Fe, NM 87507-0443 2020-03-18
1336620053 Patricia Ann Woodall Family Medicine 66 Apache Plume Dr, Santa Fe, NM 87508-9384 2018-08-22
1417201732 Niki Hodges Family Medicine 14310 Highway 6, Santa Fe, TX 77517-3421 2012-11-08
1891055281 William Mccormick Bowen Family Medicine 5501 Herrera Dr Suite B, Christus St. Vincent Urgent Care Entrada Contenta, Santa Fe, NM 87507-2677 2012-05-21
1245597970 Thomas William Longley Family Medicine 454 St. Michaels Drive, Santa Fe, NM 87505 2012-04-19
1215203385 Joseph M Molina Md Professional Corporation-southern California Molina Family Medicine 1714 St. Michaels Drive, Suite #1, Santa Fe, NM 87505-6059 2012-03-22
1255625687 Eric Grasser Md LLC Family Medicine 1925 Aspen Dr Ste 502a, Santa Fe, NM 87505-5559 2011-06-02
1740570175 Stephanie V Lucero Family Medicine 1713 Nm 502, Santa Fe, NM 87506-8931 2011-04-19
1285946947 Abbas Khoshdel Family Medicine 799 Camino Francisca, Santa Fe, NM 87506-6100 2010-07-10
1861652083 Maria Ramirez-atamoros Family Medicine 431 Saint Michaels Dr Ste B, Suite B, Santa Fe, NM 87505-8606 2008-06-11
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Competitor

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City SANTA FE
Zip Code 87505

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Dataset Information

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.

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