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SAN JUAN REGIONAL MEDICAL CENTER INC
NPI 1003296534
Urology in Farmington, NM

Active since May 29, 2015CLIA 32D0536130 · Accreditation
2700 FARMINGTON AVE, BUILDING E, SUITE 1, FARMINGTON, NM 87401(505) 609-6300(505) 609-6301 Get Directions Write a Review

NPPES record last updated: July 16, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About San Juan Regional Medical Center Inc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SAN JUAN REGIONAL MEDICAL CENTER INC (NPI 1003296534), doing business as San Juan Regional Urology, is a healthcare organization registered as an urology in Farmington, New Mexico and active in the NPI registry since May 2015. The organization holds an CLIA Accreditation certificate valid through February 27, 2027 and lists Kim Byrd, Administrative Director Of Reimburs, as its authorized official.

NPPES Registry Identity

NPI1003296534
Entity TypeOrganization
Primary Taxonomy208800000X
Legal Business NameSAN JUAN REGIONAL MEDICAL CENTER INC
Location Address2700 FARMINGTON AVE, BUILDING E, SUITE 1Farmington, NM 87401-4559
Mailing AddressPo Box 844088Dallas, TX 75284-4088 · (505) 609-2258 · Fax (505) 609-2259
Phone(505) 609-6300
Fax(505) 609-6301
Organization SubpartNo
Authorized OfficialKim ByrdAdministrative Director Of Reimburs · (505) 609-2258
Enumeration DateMay 29, 2015
Last NPPES UpdateJuly 16, 2025
NPPES CertifiedJuly 16, 2025
✔ NPI 1003296534 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyUrologyAllopathic & Osteopathic Physicians
Taxonomy Code208800000X
Definition
A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures.
2700 FARMINGTON AVE, Farmington, NM 87401
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Other Names 1

Doing Business AsSan Juan Regional Urology

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

San Juan Regional Medical Center Inc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

368

Medicare enrollment records show 368 clinicians reassign Medicare billing to San Juan Regional Medical Center Inc, which bills Medicare for the services they deliver. Of these, 3 practice at this address and 171 within 10 miles. Listed here are the 20 practicing nearest to this location.

Clinicians by Medicare Specialty 32

Internal Medicine62
Nurse Practitioner47
Certified Registered Nurse Anesthetist (CRNA)45
Emergency Medicine41
Gastroenterology21
Family Practice15
Psychiatry15
Obstetrics/Gynecology14
24 other specialties108

Nearest to this location (20)

See all 368
Stephen Mannas, MD
Urology
NPI 1528598000
2700 FARMINGTON AVE STE 1
Farmington, NM 87401
(505) 609-6830
✔ PECOS✔ Accepts MedicareSame address
Daniel Mannas, M.D.
Urology
NPI 1811287782
2700 FARMINGTON AVE BLDG E STE 1
Farmington, NM 87401
(505) 609-6380
✔ PECOS✔ Accepts MedicareSame address
Christopher Taylor, MD
Urology
NPI 1871813964
2700 FARMINGTON AVE BUILDING E, SUITE 1
Farmington, NM 87401
(505) 609-6380
✔ PECOS✔ Accepts MedicareSame address
Dmitry Garmaev
Pain Management
NPI 1720321532
2500 FARMINGTON AVE
Farmington, NM 87401
(505) 609-6830
✔ PECOS✔ Accepts Medicare0.1 mi
Jonathan Jones, MD
Interventional Pain Management
NPI 1518178763
2500 FARMINGTON AVE
Farmington, NM 87401
(505) 609-6830
✔ PECOS✔ Accepts Medicare0.1 mi
Richard Breeden, M.D.
Neurology
NPI 1598785826
2300 E 30TH ST STE B-102
Farmington, NM 87401
(505) 609-6790
✔ PECOS0.1 mi
Amylia Black, CRNA
Certified Registered Nurse Anesthetist (CRNA)
NPI 1881947372
2300 E 30TH ST BLDG A
Farmington, NM 87401
(505) 564-2300
✔ Accepts Medicare0.2 mi
Bryan Broadbent, DPM
Podiatry
NPI 1215011218
2300 E 30TH ST BLDG D-101
Farmington, NM 87401
(505) 226-7893
✔ PECOS✔ Accepts Medicare0.2 mi
Tyson Christensen, M.D.
Orthopedic Surgery
NPI 1326454125
2300 E 30TH ST STE 101
Farmington, NM 87401
(505) 208-6280
✔ PECOS✔ Accepts Medicare0.2 mi
Clifford Goldthorpe, D.O.
Orthopedic Surgery
NPI 1871941054
2300 E 30TH ST BLDG D-101
Farmington, NM 87401
(505) 208-6280
✔ PECOS✔ Accepts Medicare0.2 mi
Adam Johnson, M.D.
Orthopedic Surgery
NPI 1407073687
2300 E 30TH ST BLDG D
Farmington, NM 87401
(505) 208-6280
✔ PECOS✔ Accepts Medicare0.2 mi
Jaren Lagreca, M.D.
Orthopedic Surgery
NPI 1245720457
2300 E 30TH ST STE 101
Farmington, NM 87401
(505) 208-6280
✔ PECOS✔ Accepts Medicare0.2 mi
Jason Lucas, DO
Orthopedic Surgery
NPI 1598749061
2300 E 30TH ST BLDG D
Farmington, NM 87401
(505) 208-6280
✔ PECOS✔ Accepts Medicare0.2 mi
Taffeta Troutner, NP
Nurse Practitioner
NPI 1205280096
2300 E 30TH ST STE B-102
Farmington, NM 87401
(505) 609-6790
✔ PECOS✔ Accepts Medicare0.2 mi
Laura Waymire, M.D.
Neurology
NPI 1104141233
2300 E 30TH ST STE B-102
Farmington, NM 87401
(505) 609-6790
✔ PECOS✔ Accepts Medicare0.2 mi
Preston Wolff, PT, DPT
Physical Therapist in Private Practice
NPI 1023615309
1800 E 30TH ST STE A
Farmington, NM 87401
(505) 208-6280
✔ Accepts Medicare0.4 mi
Lawrence Ward, DPM
Podiatry
NPI 1629029541
3180 N BUTLER AVE BLDG 300
Farmington, NM 87401
(505) 327-1400
✔ PECOS✔ Accepts Medicare1.0 mi
Priscilla Roth-Wall, PH.D.
Clinical Psychologist
NPI 1457386963
3751 N BUTLER AVE STE 115
Farmington, NM 87401
(505) 787-2640
✔ PECOS1.1 mi
David Dunworth, D.O.
General Surgery
NPI 1245341635
802 E NAVAJO ST
Farmington, NM 87401
(505) 215-1120
✔ PECOS✔ Accepts Medicare1.5 mi
Frank Arnold, M.D.
Family Practice
NPI 1417982679
4820 E MAIN ST
Farmington, NM 87402
(505) 609-6495
✔ PECOS✔ Accepts Medicare1.8 mi
See all 368 clinicians

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Accreditation 32D0536130

San Juan Regional Medical Center · Farmington, NM
Active · expires Feb 27, 2027
CLIA Number32D0536130
Laboratory TypeHospital
Certificate Effective DateFebruary 28, 2025
Certificate Expiration DateFebruary 27, 2027
Laboratory DirectorDr. Scott P. Otteson
Laboratory Phone(505) 609-6385
Laboratory LocationSan Juan Regional Medical Center801 W Maple St Attn Laboratory, Farmington, NM 87401
CLIA data matches this NPI record on: Name
This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is San Juan Regional Medical Center Inc's NPI number?

The NPI number for San Juan Regional Medical Center Inc is 1003296534. It was assigned to this organization in the NPPES registry on May 29, 2015. The provider is doing business as San Juan Regional Urology.

Where is San Juan Regional Medical Center Inc located?

San Juan Regional Medical Center Inc is located at 2700 Farmington Ave Building E, Suite 1, Farmington, NM 87401. The listed phone number is (505) 609-6300.

What is San Juan Regional Medical Center Inc's specialty?

The primary specialty registered for this NPI is Urology with taxonomy code 208800000X.

Is San Juan Regional Medical Center Inc enrolled in Medicare?

Yes. San Juan Regional Medical Center Inc is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through San Juan Regional Medical Center Inc?

According to the CMS Revalidation Reassignment List (October 2026 release), 368 clinicians in 32 Medicare specialties reassign their Medicare billing to San Juan Regional Medical Center Inc. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Internal Medicine (62), Nurse Practitioner (47) and Certified Registered Nurse Anesthetist (CRNA) (45). Of these, 3 practice at this address and 171 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does San Juan Regional Medical Center Inc hold a CLIA laboratory certificate?

Yes. A Certificate of Accreditation (number 32D0536130) is associated with this NPI, valid through February 27, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for San Juan Regional Medical Center Inc was last updated on July 16, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.