| Taos Picuris Health Ctr | |
|
1090 Goat Springs Road Taos NM 87571-1946 | |
| (575) 758-6978 | |
| (575) 751-5211 |
| Full Name | Taos Picuris Health Ctr |
|---|---|
| Speciality | Clinic/Center |
| Location | 1090 Goat Springs Road, Taos, New Mexico |
| Authorized Official Name and Position | Gail W Osborne (ADMINISTRATIVE OFFICER) |
| Authorized Official Contact | 5757586978 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Taos Picuris Health Ctr Po Box 95452 Cleveland OH 44101-0033 Ph: (575) 758-6978 | Taos Picuris Health Ctr 1090 Goat Springs Road Taos NM 87571-1946 Ph: (575) 758-6978 |
| NPI Number | 1548372071 |
|---|---|
| Provider Enumeration Date | 08/31/2006 |
| Last Update Date | 09/26/2023 |
| Medicare PECOS PAC ID | 5193638245 |
|---|---|
| Medicare Enrollment ID | O20031106000188 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548372071 | NPI | - | NPPES |
| HSZ189 | Other | NM | MEDICARE PART B |
| K3543 | Medicaid | NM |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Richard T Caldwell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1952392532 PECOS PAC ID: 0143294785 Enrollment ID: I20040820000546 |
| Provider Name | Timothy T Mccay |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1245221761 PECOS PAC ID: 2961456538 Enrollment ID: I20050621000935 |
| Provider Name | Dean Roy Fullingim |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1770574253 PECOS PAC ID: 5193710929 Enrollment ID: I20050712000568 |
| Provider Name | Sheila Malone Taber |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1447241971 PECOS PAC ID: 1557311495 Enrollment ID: I20050715000344 |
| Provider Name | George E Erbacher |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1326039801 PECOS PAC ID: 5991755829 Enrollment ID: I20050720000214 |
| Provider Name | Felino A Pascual |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1801877055 PECOS PAC ID: 6002801834 Enrollment ID: I20050728000628 |
| Provider Name | John S Dennis |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1871584060 PECOS PAC ID: 3173594389 Enrollment ID: I20050728000739 |
| Provider Name | Meri Paige Gerling |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1114978251 PECOS PAC ID: 2365492469 Enrollment ID: I20060112000625 |
| Provider Name | Darlene Marks |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205862521 PECOS PAC ID: 9436049400 Enrollment ID: I20060705000276 |
| Provider Name | John D Walton |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1326096850 PECOS PAC ID: 3375546054 Enrollment ID: I20060907000113 |
| Provider Name | Thomas J Faber |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1235120908 PECOS PAC ID: 8426056482 Enrollment ID: I20061129000489 |
| Provider Name | Myeong S Yoon |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1497722342 PECOS PAC ID: 0042227266 Enrollment ID: I20070219000272 |
| Provider Name | Judith Wolfstein |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1013914456 PECOS PAC ID: 0345135232 Enrollment ID: I20081203000298 |
| Provider Name | Filiz Azize Smith |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1104814607 PECOS PAC ID: 2860554300 Enrollment ID: I20081217000678 |
| Provider Name | Jason Pack |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1861549743 PECOS PAC ID: 3375623887 Enrollment ID: I20090305000362 |
| Provider Name | Ralph Noah |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1669458741 PECOS PAC ID: 6800966284 Enrollment ID: I20090326000463 |
| Provider Name | Hooby P Yoon |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1508066473 PECOS PAC ID: 4486705779 Enrollment ID: I20090626000135 |
| Provider Name | Tamara A Singleton |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1881779304 PECOS PAC ID: 6305926288 Enrollment ID: I20090805000274 |
| Provider Name | Kelly Cole |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1699958157 PECOS PAC ID: 0648322024 Enrollment ID: I20090916000496 |
| Provider Name | Jeremy Scott Fullingim |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1255537304 PECOS PAC ID: 5092867762 Enrollment ID: I20090917000124 |
| Provider Name | Damon L Brooks |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1558583963 PECOS PAC ID: 4587715354 Enrollment ID: I20090917000269 |
| Provider Name | Laura H Veal |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225364599 PECOS PAC ID: 0446393250 Enrollment ID: I20100202000541 |
| Provider Name | Michelle M Ponder |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1447399415 PECOS PAC ID: 4880787217 Enrollment ID: I20100428000166 |
| Provider Name | Christos Vassiliou |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1053567784 PECOS PAC ID: 8820120454 Enrollment ID: I20100719000117 |
| Provider Name | Arthur W Lynch |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1225223399 PECOS PAC ID: 5890747539 Enrollment ID: I20100826000263 |
| Provider Name | Lance I Ray |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1629103775 PECOS PAC ID: 6901921345 Enrollment ID: I20100909000104 |
| Provider Name | Nina C Jones |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1003877754 PECOS PAC ID: 6901833367 Enrollment ID: I20110414000371 |
| Provider Name | Stephen A Back |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1639302060 PECOS PAC ID: 3476723594 Enrollment ID: I20110829000547 |
| Provider Name | Brian F Hanley |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1467657841 PECOS PAC ID: 1355511924 Enrollment ID: I20110909002578 |
| Provider Name | Patrick B O Hayre |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1518134352 PECOS PAC ID: 2264695402 Enrollment ID: I20120730000568 |
| Provider Name | Leila Danielle See |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1013164268 PECOS PAC ID: 6800059064 Enrollment ID: I20120810000291 |
| Provider Name | Matthew Prazak |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699046854 PECOS PAC ID: 3375703341 Enrollment ID: I20120814000339 |
| Provider Name | Jeffrey W Shelton |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1194864074 PECOS PAC ID: 7719141639 Enrollment ID: I20120823000396 |
| Provider Name | Mary J Vitt |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1073844569 PECOS PAC ID: 6507015666 Enrollment ID: I20121004000432 |
| Provider Name | Joshua M Timock |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1841386240 PECOS PAC ID: 6901807478 Enrollment ID: I20130502000278 |
| Provider Name | Raymond Anthony Shelko |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1053442483 PECOS PAC ID: 2466691639 Enrollment ID: I20130619000198 |
| Provider Name | Jonathon D Kirkland |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1639315260 PECOS PAC ID: 4789823139 Enrollment ID: I20130726000027 |
| Provider Name | Carmine Dimartino |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1689995953 PECOS PAC ID: 8820231574 Enrollment ID: I20130827000882 |
| Provider Name | James N Pham |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1306089578 PECOS PAC ID: 4284876558 Enrollment ID: I20130911000061 |
| Provider Name | Todd A Powell |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1821375361 PECOS PAC ID: 3971777020 Enrollment ID: I20131017001423 |
| Provider Name | Brooke White |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1558679035 PECOS PAC ID: 4688807464 Enrollment ID: I20140516000548 |
| Provider Name | Joe W Snavely |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1275732992 PECOS PAC ID: 6406070770 Enrollment ID: I20140609000379 |
| Provider Name | Nicholas Bull |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1487968756 PECOS PAC ID: 6507099389 Enrollment ID: I20140821001827 |
| Provider Name | Peter J Mostert |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1326346875 PECOS PAC ID: 2860635844 Enrollment ID: I20140828001578 |
| Provider Name | Bo Yon Choi |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1053551721 PECOS PAC ID: 5890920870 Enrollment ID: I20140925002205 |
| Provider Name | Lance Mcadams |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1497089205 PECOS PAC ID: 5991028730 Enrollment ID: I20141230002145 |
| Provider Name | Chelsia Park |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1306109442 PECOS PAC ID: 5799008561 Enrollment ID: I20141231000842 |
| Provider Name | Marcia Oliver |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1396722849 PECOS PAC ID: 1254592892 Enrollment ID: I20150415001022 |
| Provider Name | Kyle G Flowers |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1063710580 PECOS PAC ID: 2769703107 Enrollment ID: I20150610001387 |
| Provider Name | Tanakorn Songrug |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1073847455 PECOS PAC ID: 7416184478 Enrollment ID: I20150615002064 |
| Provider Name | Donald Von Borstel |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1275887663 PECOS PAC ID: 3779894860 Enrollment ID: I20150617001059 |
| Provider Name | Marcus Brown |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1275776965 PECOS PAC ID: 8224250816 Enrollment ID: I20150910000185 |
| Provider Name | Catherine A Mcqueen |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1356717680 PECOS PAC ID: 2264742477 Enrollment ID: I20151029002785 |
| Provider Name | Donald E Butterfield |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1225187479 PECOS PAC ID: 9931407574 Enrollment ID: I20160414000483 |
| Provider Name | George Polanco |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1326019332 PECOS PAC ID: 0244210755 Enrollment ID: I20160713002114 |
| Provider Name | Ronald A Stillerman |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1679549166 PECOS PAC ID: 7214958370 Enrollment ID: I20161122000168 |
| Provider Name | Bart M Rowlett |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1104945526 PECOS PAC ID: 5092602102 Enrollment ID: I20170215002368 |
| Provider Name | Sindhura Alapati |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1528370319 PECOS PAC ID: 7012220189 Enrollment ID: I20170315001813 |
| Provider Name | Emad Hamid |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1457553588 PECOS PAC ID: 7618021999 Enrollment ID: I20170502001404 |
| Provider Name | Kenneth E Mann |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1851398713 PECOS PAC ID: 7113985441 Enrollment ID: I20170519000382 |
| Provider Name | Adam Boice Foster |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1811230311 PECOS PAC ID: 6406123504 Enrollment ID: I20170526000322 |
| Provider Name | Blake Edward Weaver |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1497785893 PECOS PAC ID: 6103890975 Enrollment ID: I20170629001468 |
| Provider Name | Kevin L Hamm |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1578657623 PECOS PAC ID: 8022919620 Enrollment ID: I20171014000017 |
| Provider Name | Marko A Miljkovic |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1821208414 PECOS PAC ID: 2860550456 Enrollment ID: I20171130002727 |
| Provider Name | Ali Saleem |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1639448020 PECOS PAC ID: 1759501562 Enrollment ID: I20171207001100 |
| Provider Name | Allison Tracy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912339870 PECOS PAC ID: 9436488103 Enrollment ID: I20190905000146 |
| Provider Name | Lisa R Spero |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528604303 PECOS PAC ID: 7113356866 Enrollment ID: I20200401002639 |
| Provider Name | Lakitta Monchelle Woods Dwelle |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1174786925 PECOS PAC ID: 9537321161 Enrollment ID: I20200423001261 |
| Provider Name | Patrick U Iyahen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1528493350 PECOS PAC ID: 7618351404 Enrollment ID: I20220827000633 |
| Provider Name | Alice Ann Kaniff |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1477716926 PECOS PAC ID: 9638358831 Enrollment ID: I20231011003088 |
El Centro Family Health Taos Ms Sbhc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 235 Paseo Del Canon E, Taos, NM 87571 Phone: 575-751-8032 Fax: 575-758-7088 | |
El Centro Family Health Taos Hs Sbhc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 134 Cervantes St, Taos, NM 87571 Phone: 575-751-8032 Fax: 505-753-7218 | |
Taos Health Systems Primary Care Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1329 Gusdorf Rd, Taos, NM 87571 Phone: 575-737-3415 Fax: 575-737-3416 | |
Family Practice Associates Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 630 Paseo Del Pueblo Sur, Taos, NM 87571 Phone: 505-758-3005 | |
White Crane Clinic, P.a. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1332 Gusdorf Rd, Ste. E, Taos, NM 87571 Phone: 505-758-2700 Fax: 505-758-2700 | |
Taos Whole Health Integrative Care, Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1331 Maestas Rd, Taos, NM 87571 Phone: 575-776-7806 Fax: 575-224-3348 |