Provider Type Icon

MOLINA MEDICAL GROUP OF NEW MEXICO PC NPI 1194150318


NPI Information

NPI: 1194150318
Provider Name: MOLINA MEDICAL GROUP OF NEW MEXICO, PC
Classification: Family Medicine - 207Q00000X
Entity Type: Organization
Address:
1714 SAINT MICHAELS DR # 1
SANTA FE, NM
ZIP 87505
Phone: (505) 490-4042
Get Directions

MOLINA MEDICAL GROUP OF NEW MEXICO, PC is a family medicine in Santa Fe, NM. The provider is 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. MOLINA MEDICAL GROUP OF NEW MEXICO, PC NPI is 1194150318. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

1714 SAINT MICHAELS DR # 1
SANTA FE, NM
ZIP 87505-617
Phone: (505) 490-4042
Fax: (877) 846-3680

The provider's authorized official is Gloria Calderon .
The authorized official title is Vp, Clinic Operations and has the following contact phone number (562) 499-6191.

The enumeration date for this NPI number is 9/6/2013 and was last updated on 5/27/2014.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1208000000XPediatricsNEW MEXICONo
2363L00000XNurse PractitionerNEW MEXICONo
3363A00000XPhysician AssistantNEW MEXICONo
4207R00000XInternal MedicineNEW MEXICONo
5104100000XSocial WorkerNEW MEXICONo
6207Q00000XFamily MedicineNEW MEXICOYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
172035005-EFF.1/21/14MEDICAIDNEW MEXICO
2342566-EFF. 1/1/14MEDICARE PINNEW MEXICO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.