DR. LETICIA MOEDANO MD
NPI 1831688647
Family Medicine in Santa Fe, NM

Q: What is Leticia Moedano's NPI number?

The NPI number for Leticia Moedano is 1831688647. It was assigned to this individual provider in the NPPES registry on May 7, 2018.

Q: What is Leticia Moedano's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Q: When was this NPI record last updated?

The NPPES record for Leticia Moedano was last updated on January 13, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years 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.

Active since May 07, 2018PECOS EnrolledAccepts Medicare Assignment

2025 GALISTEO ST, SANTA FE, NM 87505(602) 655-6300 Get Directions Write a Review

NPPES record last updated: January 13, 2023. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Jan 13, 2023, Oct 22, 2021, May 7, 2018 (3 updates tracked since 2018).

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About Dr. Leticia Moedano Md NPPES

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

DR. LETICIA MOEDANO MD (NPI 1831688647) is an individual family medicine provider in Santa Fe, New Mexico, licensed in New Mexico (MD2022-1484) and active in the NPI registry since May 2018. She is enrolled in Medicare PECOS, is affiliated with Christus St Vincent Regional Medical Center, and is a graduate of University Of Arizona College Of Medicine (2018).

NPPES Registry Identity

NPI1831688647

Entity TypeIndividualFemale

Primary Taxonomy207Q00000X

Provider Legal NameDR. LETICIA MOEDANOCredential: MD

Location Address2025 GALISTEO STSanta Fe, NM 87505-2101

Mailing Address2177 S 29th AveYuma, AZ 85364-6042 · (928) 580-9811

Phone(602) 655-6300

Sole ProprietorYes

Medical School CMSUniversity Of Arizona College Of MedicineGraduated 2018

Enumeration DateMay 7, 2018

Last NPPES UpdateJanuary 13, 20233 updates tracked since enumeration

NPPES CertifiedJanuary 13, 2023

✔ NPI 1831688647 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

Licenses✔ Licensed in NM · MD2022-1484✔ Licensed in AZ · 63273

Definition

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.

2025 GALISTEO ST, Santa Fe, NM 87505

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Leticia Moedano Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID42561565

PECOS Enrollment IDI20230120000099

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

Medicare enrollment records show Leticia Moedano reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

St. Vincent Hospital

Same address

Rehabilitation Practitioner

2025 SOUTH GALISTEO ST
Santa Fe, NM 87505

Reassigned Medicare billing, New Mexico enrollment
399 clinicians in this Medicare group

NPI 1568589653 (505) 995-4901

District Medical Group, Inc

369 mi

Psychiatry

570 W BROWN RD, ADMINISTRATION
Mesa, AZ 85201

Reassigned Medicare billing, Arizona enrollment
1,490 clinicians in this Medicare group

NPI 1124251020 (480) 344-2000

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

Areas of Expertise CMS Part B claims 11

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

288 services162 patients

Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215

This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.

132 services95 patients

Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439

An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.

98 services98 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

43 services43 patients

Administration of influenza virus vaccine G0008

The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.

39 services38 patients

Influenza vaccine split virus, preservative free 90662

The Influenza Vaccine Split Virus, preservative-free, is a flu shot to protect against the influenza virus. It is made from parts of inactivated flu viruses and doesn't contain preservatives, reducing potential side effects. It helps your body develop immunity to the flu.

37 services36 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Christus St Vincent Regional Medical Center

Acute Care Hospitals · Santa Fe, NM

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number320002

Location455 St Michael's DriveSanta Fe, NM 87505 · Santa Fe County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 87505 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$84.79 typical visit price

range $54.26 – $166.80

Typical copayment $21.19 (range $13.56 – $41.70)

Most-billed visit code 99203

Established Patient

$96.38 typical visit price

range $17.00 – $135.35

Typical copayment $24.09 (range $4.25 – $33.83)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 13

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JACQUELYN BELINSKY CNP

Nurse Practitioner