DR. JOHN E. BROOM (NPI# 1568470706) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568470706 |
| Entity Type | Individual |
| Full Name | DR. JOHN E. BROOM |
| Credential | M.D. |
| Practice Address |
455 Saint Michaels Dr Santa Fe NM 87505-7601 |
| Mailing Address |
455 Saint Michaels Dr Medical Staff Office Santa Fe NM 87505-7601 |
| Practice Telephone | 5058205227 |
| Mailing Telephone | 5058205227 |
| Enumeration Date | 2006-08-04 |
| Last Update Date | 2008-01-21 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | A48242 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| UHC | 1103063 | 01 | |
| NM | BCBS NM | NM002A14 | 01 |
| CA | 00A482420 | 05 | |
| NM | 93153775 | 05 | |
| MOLINA | QMP000003384301 | 01 |
| Street Address |
455 SAINT MICHAELS DR |
| City | SANTA FE |
| State | NM |
| Zip Code | 87505-7601 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124021233 | Bryan W Goss | Radiology | 455 Saint Michaels Dr, Santa Fe, NM 87505-7601 | 2005-05-23 |
| 1194324996 | Ashley Dawn Powell | Pharmacist | 455 Saint Michaels Dr, Santa Fe, NM 87505-7601 | 2020-10-22 |
| 1356949549 | Leo Santos | Nurse Practitioner | 455 Saint Michaels Dr, Santa Fe, NM 87505-7601 | 2020-10-11 |
| 1538772751 | Audrea Nicole Nolan | Nurse Anesthetist, Certified Registered | 455 Saint Michaels Dr, Santa Fe, NM 87505-7601 | 2020-08-27 |
| 1912510165 | Antonio Samuel Gervais | Registered Nurse | 455 Saint Michaels Dr, Santa Fe, NM 87505-7601 | 2020-08-27 |
| 1326664939 | Jesse August Schedler | Nurse Anesthetist, Certified Registered | 455 Saint Michaels Dr, Santa Fe, NM 87505-7601 | 2020-06-19 |
| 1154945830 | Brett Elliff | Registered Nurse | 455 Saint Michaels Dr, Santa Fe, NM 87505-7601 | 2020-05-29 |
| 1275156275 | Christopher Parrish | Registered Nurse | 455 Saint Michaels Dr, Santa Fe, NM 87505-7601 | 2020-05-26 |
| 1255971453 | Juliana Ramos | Nurse Anesthetist, Certified Registered | 455 Saint Michaels Dr, Santa Fe, NM 87505-7601 | 2020-01-15 |
| 1134766512 | Ying Xiong | Nurse Anesthetist, Certified Registered | 455 Saint Michaels Dr, Santa Fe, NM 87505-7601 | 2019-12-05 |
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| 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 Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316589799 | Daniel Marc Sosin | Internal Medicine | 1190 S Saint Francis Dr # N-1053, Santa Fe, NM 87505-4173 | 2019-10-17 |
| 1558875260 | Northern Nm Medical Management, LLC | Internal Medicine | 1421 Luisa Street, Suite B, Santa Fe, NM 87505-4073 | 2017-11-17 |
| 1508270745 | Mehul Daulat | Internal Medicine | 2213 Brothers Rd Ste 700, Santa Fe, NM 87505 | 2014-06-16 |
| 1346595774 | Trenton Tyler Sensiba | Internal Medicine | 465 Saint Michaels Dr Ste 116, Santa Fe, NM 87505 | 2012-07-23 |
| 1902199797 | Luke Martin Gabe | Internal Medicine | 465 Saint Michaels Dr Ste 209, Santa Fe, NM 87505 | 2011-05-26 |
| 1740515584 | Hospitalists New Mexico PC | Internal Medicine | 35 Blue Jay Dr, Santa Fe, NM 87506-8509 | 2009-10-13 |
| 1336381342 | Aamer Rehman | Internal Medicine | 454 St Michaels Dr, Santa Fe, NM 87505-7602 | 2009-04-06 |
| 1366695272 | First Care Inc | Internal Medicine | 4001 Office Ct Ste 405, Santa Fe, NM 87507-4916 | 2008-10-23 |
| 1952505182 | David Steven Riley | Internal Medicine | 6 Amigos Ln, Santa Fe, NM 87508-4584 | 2007-06-12 |
| 1174743660 | Howard Neil Schwartz | Internal Medicine | 404 Brunn School Road, Building C, Santa Fe, NM 87505-2612 | 2007-04-26 |
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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.