| San Miguel Hospital Corporation | |
|
2515 Ridge Runner Rd Las Vegas NM 87701-4972 | |
| (505) 425-2662 | |
| Not Available |
| Full Name | San Miguel Hospital Corporation |
|---|---|
| Speciality | General Practice |
| Location | 2515 Ridge Runner Rd, Las Vegas, New Mexico |
| Authorized Official Name and Position | Laura J Fey (SR. DIRECTOR PHYSICIAN REV CYCLE) |
| Authorized Official Contact | 6152213641 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| San Miguel Hospital Corporation Po Box 5009 Brentwood TN 37024-5009 Ph: (615) 221-3722 | San Miguel Hospital Corporation 2515 Ridge Runner Rd Las Vegas NM 87701-4972 Ph: (505) 425-2662 |
| NPI Number | 1851747216 |
|---|---|
| Provider Enumeration Date | 05/04/2016 |
| Last Update Date | 07/07/2023 |
| Medicare PECOS PAC ID | 8921097502 |
|---|---|
| Medicare Enrollment ID | O20050421000171 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851747216 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| Provider Name | Wietske Moore |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235291394 PECOS PAC ID: 9638073760 Enrollment ID: I20031120000990 |
| Provider Name | Raymond F Ortiz |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1497708754 PECOS PAC ID: 8325086408 Enrollment ID: I20050419001420 |
| Provider Name | Franklin Miller |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1659375194 PECOS PAC ID: 6204908346 Enrollment ID: I20080707000071 |
| Provider Name | Susan L Miller |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1538262407 PECOS PAC ID: 0648369280 Enrollment ID: I20130611000801 |
| Provider Name | Michael Dunkle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306389846 PECOS PAC ID: 5991080079 Enrollment ID: I20190722001471 |
| Provider Name | Alicia Padilla |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497492912 PECOS PAC ID: 1850772575 Enrollment ID: I20220713000323 |
Las Vegas Primary Care, Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2020 7th St, Las Vegas, NM 87701 Phone: 505-425-6731 Fax: 505-454-1185 | |
State Of New Mexico Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3695 Hot Springs Blvd, Las Vegas, NM 87701 Phone: 505-454-2100 | |
Sunrise Clinics Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 412 Santa Fe St, Las Vegas, NM 87701 Phone: 505-426-2599 Fax: 877-553-1272 | |
Sangre De Cristo Health And Wellness Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 830 Airport Rd, Las Vegas, NM 87701 Phone: 505-718-6319 | |
San Miguel Clinic Corp Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 108 Legion Dr Ste A, Las Vegas, NM 87701 Phone: 505-454-9499 | |
Sunrise Clinics Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1725 New Mexico Ave, Las Vegas, NM 87701 Phone: 505-426-2599 Fax: 877-553-1272 | |
San Miguel Hospital Corporation Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 108 Legion Dr Ste A, Las Vegas, NM 87701 Phone: 505-425-2662 Fax: 505-425-6410 |